[Clinical Picture] Non-Hodgkin B-cell lymphoma involving the palate
A 69-year-old white woman without risk factors for oral cancer presented at the Plastic Surgery Unit of the University Hospital of Palermo (Palermo, Sicily) in January, 2016, with a fetid and bleeding tumour on the left side of the palate (figure). The mass had developed about 6 months previously and had grown rapidly. The initial suspected diagnosis was squamous cell carcinoma of the oral cavity. No specific other symptoms were reported and her blood tests were almost normal, with the exception of a non-specific state of malnutrition due to a reduced food intake, and anaemia due to malnutrition and bleeding from the tumou...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Sara Di Lorenzo, Bartolo Corradino, Vera Panzarella Tags: Clinical Picture Source Type: research

[Policy Review] Incorporating the patient experience into regulatory decision making in the USA, Europe, and Canada
The clinical development of cancer therapeutics is a global undertaking, and incorporation of the patient experience into the clinical decision-making process is of increasing interest to the international regulatory and health policy community. Disease and treatment-related symptoms and their effect on patient function and health-related quality of life are important outcomes to consider. The identification of methods to scientifically assess, analyse, interpret, and present these clinical outcomes requires sustained international collaboration by multiple stakeholders including patients, clinicians, scientists, and polic...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Paul G Kluetz, Daniel J O'Connor, Katherine Soltys Tags: Policy Review Source Type: research

[Policy Review] The My Child Matters programme: effect of public –private partnerships on paediatric cancer care in low-income and middle-income countries
In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5 ·1%, ranging from −1·5% in Venezue...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Scott C Howard, Alia Zaidi, Xueyuan Cao, Olivier Weil, Pierre Bey, Catherine Patte, Angelica Samudio, Laurie Haddad, Catherine G Lam, Claude Moreira, Augusto Pereira, Mhamed Harif, Laila Hessissen, Salma Choudhury, Ligia Fu, Miguela A Caniza, Julius Lecci Tags: Policy Review Source Type: research

[Policy Review] Combining precision radiotherapy with molecular targeting and immunomodulatory agents: a guideline by the American Society for Radiation Oncology
The practice of radiation oncology is primarily based on precise technical delivery of highly conformal, image-guided external beam radiotherapy or brachytherapy. However, systematic research efforts are being made to facilitate individualised radiation dose prescriptions on the basis of gene-expressssion profiles that reflect the radiosensitivity of tumour and normal tissue. This advance in precision radiotherapy should complement those benefits made in precision cancer medicine that use molecularly targeted agents and immunotherapies. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Robert G Bristow, Brian Alexander, Michael Baumann, Scott V Bratman, J Martin Brown, Kevin Camphausen, Peter Choyke, Deborah Citrin, Joseph N Contessa, Adam Dicker, David G Kirsch, Mechthild Krause, Quynh-Thu Le, Michael Milosevic, Zachary S Morris, Jann Tags: Policy Review Source Type: research

[Perspectives] Investigators' response
In the PORTEC-3 trial, adjuvant chemotherapy given during and after radiotherapy improved failure-free survival (FFS) in women with high-risk endometrial cancer, compared with radiotherapy alone. Overall survival was higher than expected at the time of trial design and the higher overall survival observed with chemoradiotherapy did not reach significance. We agree that analysis of overall survival with a longer follow-up is warranted in the PORTEC-3 trial. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Remi A Nout, Melanie E Powell, Stephanie M de Boer, Carien L Creutzberg Tags: Perspectives Source Type: research

[Perspectives] Treatment toxicity in endometrial cancer: can we identify and manage it better?
We thank Dr Melanie Powell and Dr Remi Nout for taking the time to share their expertise on high-risk endometrial cancer during the March 17 –18 #radonc journal club on Twitter. During our conversation, we discussed the results of the PORTEC-3 trial, which confirms the findings of other randomised trials: a reduced risk of relapse by adding chemotherapy to radiotherapy, without improving overall survival. The risk of distant relapse wa s not significantly lower with chemotherapy, suggesting that a clear survival benefit might not be observed with a longer follow-up. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Matthew S Katz, Lesley Smith, Richard Simcock Tags: Perspectives Source Type: research

[Perspectives] Next generation of cancer survivors —a GP perspective
I first met Sarah 5 years ago in one of my Monday morning surgeries. She was 41 years old and, other than attending for the odd minor illness, we hadn't seen much of her over the past few years. She told me she had started experiencing increasing shortness of breath when exercising. She had a body-mass index of 22, had never smoked, exercised 3 –4 times per week, and had no family history of heart or lung disease. There was nothing abnormal that I could find on examination, and a comprehensive set of blood test results were also normal. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Sinead Clarke Tags: Perspectives Source Type: research

[Perspectives] Does global oncology need artificial intelligence?
Discussing the use of artificial intelligence (AI) for cancer care in low- and middle-income countries (LMICs) might seem like a paradox, but new technologies have sometimes reached LMICs faster than cancer drugs on the WHO Essential Medicines List. One example of AI already starting to take hold in cancer care in some LMICs is Watson for Oncology, developed by IBM in partnership with the Memorial Sloan Kettering Cancer Center (MSKCC, New York, NY, USA). Watson for Oncology is a cognitive computing system developed to provide treatment recommendations based on training it receives from published medical literature, publicl...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Bishal Gyawali Tags: Perspectives Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 705 –14
Laetsch TW, DuBois SG, Mascarenhas L, et al. Larotrectinib for paediatric solid tumours harbouring NTRK gene fusions: phase 1 results from a multicentre, open-label, phase 1/2 study. Lancet Oncol 2018; 19: 705 –14—In the Summary, the following statement should have read as follows: “cohort 3 was assigned to receive a dose of 100 mg/m2 twice daily (maximum 100 mg per dose), regardless of age, equating to a maximum of 173% of the recommended adult phase 2 dose.” This correction has been made to the online version as of April 25, 2018, and the printed version is correct. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 580 –81
Grob JJ. Is there any interest in a new BRAF –MEK inhibitor combination in melanoma? Lancet Oncol 2018; 19: 580–81—In the title of this Comment, “BRAF-MEK inhibitor” was spelt incorrectly, and in the fourth paragraph one instance of the drug “encorafenib” was spelt incorrectly and the dose of encorafenib should have been “300 m g”. These corrections have been made to the online version as of April 25, 2018, and the printed Comment is correct. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Correspondence] Body-mass index and metastatic melanoma outcomes – Authors' reply
As noted by Wen and colleagues, both the patterns of melanoma and the relationship between body-mass index (BMI) and adiposity vary by race and ethnicity. The incidence of melanoma also varies greatly by geographic region. Melanoma incidence and mortality rates are about 20 –30 times higher in countries with a predominantly white population than in Asian countries.1 In the US, non-Hispanic white people account for more than 95% of cutaneous melanoma cases.2 This disparity is driven by the protective effect of darker skin against UV damage, which is the primary risk f actor for non-acral cutaneous melanoma (the most c...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Jennifer L McQuade, Carrie R Daniel, Michael A Davies Tags: Correspondence Source Type: research

[Correspondence] Body-mass index and metastatic melanoma outcomes
Although the apparent obesity paradox reported by McQuade and colleagues1 is attractive and has potential clinical implications, there are several issues that cast doubt on its validity. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hermann Nabi, Jason R Guertin, Denis Talbot, Caroline Diorio Tags: Correspondence Source Type: research

[Correspondence] Body-mass index and metastatic melanoma outcomes
Jennifer McQuade and colleagues1 reported that “obesity is associated with improved progression-free survival and overall survival compared with those outcomes in patients with normal BMI”. Set against the strengths of secondary analyses of trials, this study is undoubtedly an important contribution. They concluded that their “findings sup port the presence of an obesity paradox across the spectrum of melanoma development, progression, and treatment response”, while the supporting Comment2 interprets this relationship as meaning that high BMI has a protective and beneficial effect. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hannah Lennon, Ellena Badrick, Matthew Sperrin, Andrew G Renehan Tags: Correspondence Source Type: research

[Correspondence] Body-mass index and metastatic melanoma outcomes
We read with great interest the study conducted by Jennifer McQuade and colleagues1 reporting obesity (BMI>30 kg/m2) is associated with improved progression-free survival and overall survival in male patients with metastatic melanoma treated with targeted and immune therapies, and that this effect was not observed in women.1 However, we would query if features of body composition could better explain this observation than BMI. Although BMI is a simple, easy and readily available measure in clinical practice, it is flawed by its inability to differentiate between muscle and adipose tissue. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Louise E Daly, Aoife M Ryan, Derek G Power Tags: Correspondence Source Type: research

[Correspondence] Body-mass index and metastatic melanoma outcomes
McQuade and colleagues1 reported a significant association between high body-mass index (BMI) and outcomes in patients with metastatic melanoma treated with targeted therapy, immunotherapy, or chemotherapy in male patients. The findings remained statistically significant after being adjusted for multiple factors that could confound the interpretation. The observation was in strong contrast with current knowledge of the biology of melanoma and, as the authors described, warranted insightful investigation for explanation. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hui Wen, Ting Guo, Chenchen Feng Tags: Correspondence Source Type: research

[Correspondence] Effect of early palliative care: complex intervention and complex results – Authors' reply
We would like to thank Ishiki and colleagues for their comments. They note that the primary outcome solely focused on the difference of overall quality of life (QOL) scores between both groups at 12 weeks. As stated in our article,1 the effect of intervention on the primary outcome and other outcomes was assessed by multivariate regression analyses adjusted for baseline scores. Baseline scores were, therefore, taken into account: for the same baseline score (59 ·7) in both groups, the usual care group scored 7·6 points lower on QOL at 12 weeks compared with that of the early palliative care group. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Ga ëlle Vanbutsele, Koen Pardon, Simon Van Belle, Veerle Surmont, Martine De Laat, Roos Colman, Kim Eecloo, Veronique Cocquyt, Karen Geboes, Luc Deliens Tags: Correspondence Source Type: research

[Correspondence] Effect of early palliative care: complex intervention and complex results
We applaud the work done by Vanbutsele and colleagues1 using a highly complex palliative care intervention. However, the results are difficult to interpret, because of multiple confounders. Here, we present a couple of discussion points regarding this. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hiroto Ishiki, Takuhiro Yamaguchi, Yoshihisa Matsumoto, Daisuke Kiuchi, Eriko Satomi Tags: Correspondence Source Type: research

[Correspondence] Anti-PD-1 antibody treatment for melanoma – Authors' reply
We reported multiple ways to assess the subsequent response of TBP and did not endorse one method over another.1 Although we reported that 19% (95 of 500) of assessable patients in the TBP cohort had subsequent decreases in target lesion tumour burden of 30% or more, we also reported that this population represented only 4% of the total treated population of 2624 patients. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Julia A Beaver, Patricia Keegan, Steven Lemery, Richard Pazdur, Marc R Theoret Tags: Correspondence Source Type: research

[Correspondence] Anti-PD-1 antibody treatment for melanoma
Beaver and colleagues1 reported on the rate of radiographic response after documented disease progression by studying a pooled analysis of individual patient data provided to the US Food and Drug Administration in support of the approval of anti-programmed death receptor-1 (PD-1) therapies for patients with advanced melanoma. Defining this rate is of high importance when interpreting clinical trials of a combination of anti-PD-1 antibodies with another agent in the population of patients who did not respond to prior anti-PD-1 therapy. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Antoni Ribas, John M Kirkwood, Keith T Flaherty Tags: Correspondence Source Type: research

[Comment] Patient-reported outcomes: an essential component of oncology drug development and regulatory review
When evaluating the risks and benefits of a new cancer drug, an understanding of the ways in which a drug affects how a patient feels and functions is crucial. Without such information, clinicians, patients, researchers, and regulators are left with an incomplete picture of the properties of that product; however, this situation is the norm in drug development programmes. Despite rising interest in patient-focused drug development in the past decade,1 most drug developers still do not rigorously and comprehensively collect information directly from patients about symptoms or physical functioning in pivotal trials upon whic...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Ethan Basch Tags: Comment Source Type: research

[Editorial] Minimalism in oncology
Expenses related to cancer treatment can diminish patients' quality of life and impede delivery of high-quality care. Thus, it is worrying that, in 2017, a study showed the price of some common cancer drugs in the USA rose at a rate higher than inflation. The US senate has recently started investigating why a 40-year-old cancer drug —lomustine, which has no generic competition—has increased in price by 1400% since 2013. At the 23rd Annual Conference of the National Comprehensive Cancer Network (Orlando, FL, USA, March 22–24, 2018), oncologists had a heated debate about the congressional mandate that prohi...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: The Lancet Oncology Tags: Editorial Source Type: research

[News] Sarcopenia and adiposity linked to overall survival
Patients with non-metastatic breast cancer who have sarcopenia or high total adipose tissue at diagnosis might have an increased risk of mortality, a new study suggests. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 12, 2018 Category: Cancer & Oncology Authors: Elizabeth Gourd Tags: News Source Type: research

[Articles] Tazemetostat, an EZH2 inhibitor, in relapsed or refractory B-cell non-Hodgkin lymphoma and advanced solid tumours: a first-in-human, open-label, phase 1 study
Tazemetostat showed a favourable safety profile and antitumour activity in patients with refractory B-cell non-Hodgkin lymphoma and advanced solid tumours, including epithelioid sarcoma. Further clinical investigation of tazemetostat monotherapy is ongoing in phase 2 studies in adults and a phase 1 study for children, which are currently enrolling patients who have B-cell non-Hodgkin lymphoma and INI1-negative or SMARCA4-negative tumours. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 9, 2018 Category: Cancer & Oncology Authors: Antoine Italiano, Jean-Charles Soria, Maud Toulmonde, Jean-Marie Michot, Carlo Lucchesi, Andrea Varga, Jean-Michel Coindre, Stephen J Blakemore, Alicia Clawson, Benjamin Suttle, Alice A McDonald, Mark Woodruff, Scott Ribich, Eric Hedrick, Heike Keilhack, Tags: Articles Source Type: research

[Articles] Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial
Postoperative chemoradiotherapy did not improve overall survival compared with postoperative chemotherapy in patients with resectable gastric cancer treated with adequate preoperative chemotherapy and surgery. In view of the poor postoperative patient compliance in both treatment groups, future studies should focus on optimising preoperative treatment strategies. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 9, 2018 Category: Cancer & Oncology Authors: Annemieke Cats, Edwin P M Jansen, Nicole C T van Grieken, Karolina Sikorska, Pehr Lind, Marianne Nordsmark, Elma Meershoek-Klein Kranenbarg, Henk Boot, Anouk K Trip, H A Maurits Swellengrebel, Hanneke W M van Laarhoven, Hein Putter, Johanna W van Sandick, Tags: Articles Source Type: research

[Comment] Targeting EZH2 with tazemetostat
Enhancer of zeste homolog 2 (EZH2) is a subunit of the chromatin remodelling polycomb repressive complex 2. EZH2 is a histone methyltransferase and trimethylates histone H3 lysine 27 (H3K27). EZH2 activation contributes to epigenetic transcriptional silencing because H3K27 methylation is a repressive histone modification.1 Physiologically, EZH2 activity is high in stem or progenitor cells, in which EZH2 represses genes associated with cell cycle arrest and promotes self-renewal. However, in differentiated cells EZH2 activity is opposed by the switch/sucrose non-fermentable (SWI/SNF) multiprotein complex, which promotes ter...
Source: The Lancet Oncology - April 9, 2018 Category: Cancer & Oncology Authors: Shinichi Makita, Kensei Tobinai Tags: Comment Source Type: research

[Comment] A CRITICal period for chemoradiotherapy in gastric cancer
In western countries, there are two standards of care for adjuvant therapy of resectable gastric cancer: perioperative chemotherapy, as investigated in the UK Medical Research Council MAGIC trial,1 and postoperative chemoradiotherapy, as investigated in the US Intergroup 0116 (INT0116) trial.2 Over the past decade, clinical practice has varied depending on geographic location, with postoperative chemoradiation being practiced more commonly in North America, whereas European countries have mainly used perioperative chemotherapy. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 9, 2018 Category: Cancer & Oncology Authors: Trevor Leong Tags: Comment Source Type: research

[News] Oncologists burnout in the spotlight
The newly appointed president of the Association of Community Cancer Centers in the USA for the term 2018 –19, Thomas A Gallo (Virginia Cancer Institute, Richmond, VA, USA), has outlined his intention to make burnout the focus of his tenure. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 6, 2018 Category: Cancer & Oncology Authors: Talha Khan Burki Tags: News Source Type: research

[News] Lawsuit filed against FDA for not reviewing e-cigarettes
The American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, Truth Initiative, and five individual paediatricians are suing the US Food and Drug Administration (FDA) over their decision in July, 2017, to delay reviewing electronic cigarettes (e-cigarettes) and e-cigars. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 6, 2018 Category: Cancer & Oncology Authors: Priya Venkatesan Tags: News Source Type: research

[News] Short vs long course adjuvant chemotherapy for colon cancer
The results of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration project did not confirm the non-inferiority of 3 months of adjuvant therapy compared with the standard 6 months in patients with stage 3 colon cancer. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 6, 2018 Category: Cancer & Oncology Authors: Ashray Gunjur Tags: News Source Type: research

[News] Health care for cancer survivors in the USA
Despite a substantial increase in insurance coverage, cancer survivors in the USA face difficulties in health-care access and affordability compared with adults without cancer; however, new research suggests that after the implementation of the Affordable Care Act, these difficulties among cancer survivors showed a decreasing trend. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 6, 2018 Category: Cancer & Oncology Authors: Manjulika Das Tags: News Source Type: research

[Articles] ALT-803, an IL-15 superagonist, in combination with nivolumab in patients with metastatic non-small cell lung cancer: a non-randomised, open-label, phase 1b trial
ALT-803 in combination with nivolumab can be safely administered in an outpatient setting. The promising clinical activity observed with the addition of ALT-803 to the regimen of patients with PD-1 monoclonal antibody relapsed and refractory disease shows evidence of anti-tumour activity for a new class of agents in NSCLC. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 5, 2018 Category: Cancer & Oncology Authors: John M Wrangle, Vamsidhar Velcheti, Manish R Patel, Elizabeth Garrett-Mayer, Elizabeth G Hill, James G Ravenel, Jeffrey S Miller, Mohammad Farhad, Kate Anderton, Kathryn Lindsey, Michele Taffaro-Neskey, Carol Sherman, Samantha Suriano, Marzena Swiderska-S Tags: Articles Source Type: research

[Comment] Combining top-ranked immunotherapeutics in lung cancer
Immunotherapy is becoming widely used in the treatment of non-small-cell lung cancer (NSCLC) in light of its impressive results in both first-line and second-line settings.1 However, doctors need to accept that not all patients can be treated with this approach and much still remains to be done to improve outcomes for patients with this lethal disease. Combining new immunotherapeutic agents with existing treatments such as chemotherapy or tyrosine kinases inhibitors can have both good and bad consequences. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 5, 2018 Category: Cancer & Oncology Authors: Christian Rolfo, Evelien L J Smits Tags: Comment Source Type: research

[Articles] Tivantinib for second-line treatment of MET-high, advanced hepatocellular carcinoma (METIV-HCC): a final analysis of a phase 3, randomised, placebo-controlled study
Tivantinib did not improve overall survival compared with placebo in patients with MET-high advanced hepatocellular carcinoma previously treated with sorafenib. Although this METIV-HCC trial was negative, the study shows the feasibility of doing integral tissue biomarker studies in patients with advanced hepatocellular carcinoma. Additional randomised studies are needed to establish whether MET inhibition could be a potential therapy for some subsets of patients with advanced hepatocellular carcinoma. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 3, 2018 Category: Cancer & Oncology Authors: Lorenza Rimassa, Eric Assenat, Markus Peck-Radosavljevic, Marc Pracht, Vittorina Zagonel, Philippe Mathurin, Elena Rota Caremoli, Camillo Porta, Bruno Daniele, Luigi Bolondi, Vincenzo Mazzaferro, William Harris, Nevena Damjanov, Davide Pastorelli, Mar ía Tags: Articles Source Type: research

[Comment] Tivantinib for advanced hepatocellular carcinoma: is MET still a viable target?
The HGF-MET receptor pathway represents an attractive therapeutic target for hepatocellular carcinoma because of its crucial role in hepatocellular carcinoma development. Tivantinib, a putative MET inhibitor, did not improve overall survival compared with placebo in the METIV-HCC study, as reported in the Lancet Oncology by Lorenza Rimassa and colleagues,1 potentially casting doubt on the role of MET inhibition as a viable therapeutic strategy for patients with hepatocellular carcinoma. METIV-HCC was a randomised, double-blind, placebo-controlled, phase 3 trial of oral tivantinib (120 mg twice daily) compared with placebo ...
Source: The Lancet Oncology - April 3, 2018 Category: Cancer & Oncology Authors: Colin D Weekes, Jeffrey W Clark, Andrew X Zhu Tags: Comment Source Type: research

[Clinical Picture] Periosteal aneurysmal bone cyst
A 29-year-old woman with known type 2 diabetes presented to the musculoskeletal oncology clinic at the McGill University Health Centre (Montreal, QC, Canada) in February, 2015, with complaints of pain and swelling of her left leg for a few months. According to the patient, her swelling had increased in size over a few months before presentation. The pain was confined to the medial aspect of the proximal leg. On examination, she did not have any skin changes, but had a tender palpable mass measuring approximately 8 ·0 cm. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Thamer M Alraiyes, Nikolaos A Stavropoulos, Abdulrahman Alaseem, Sungmi Jung, Robert E Turcotte Tags: Clinical Picture Source Type: research

[Series] Oncology drugs in the crosshairs of pharmaceutical crime
Oncology drugs clearly have become a target for pharmaceutical crime. In 2016, falsified oncology drugs ranked fifth in the most commonly falsified drug category among the reports received by the Pharmaceutical Security Institute. Although the prevalence of illicit oncology drugs in the legal supply chains appears to be small, these drugs are difficult to detect, particularly in clinical practice. Forthcoming countermeasures to detect illicit drugs in high-income countries include compulsory antitampering devices and product verification technology for a risk-based selection of medicines. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Bastiaan J Venhuis, Angela E Oostlander, Domenico Di Giorgio, Ruth Mosimann, Ines du Plessis Tags: Series Source Type: research

[Series] Medication overuse in oncology: current trends and future implications for patients and society
The high cost of cancer care worldwide is largely attributable to rising drugs prices. Despite their high costs and potential toxic effects, anticancer treatments could be subject to overuse, which is defined as the provision of medical services that are more likely to harm than to benefit a patient. We found 30 studies documenting medication overuse in cancer, which included 16 examples of supportive medication overuse and 17 examples of antineoplastic medication overuse in oncology. Few specific agents have been assessed, and no studies investigated overuse of the most toxic or expensive medications currently used in can...
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Stephen M Schleicher, Peter B Bach, Konstantina Matsoukas, Deborah Korenstein Tags: Series Source Type: research

[Series] Chemotherapy medication errors
Although chemotherapy is a well established treatment modality, chemotherapy errors represent a potentially serious risk of patient harm. We reviewed published research from 1980 to 2017 to understand the extent and nature of medication errors in cancer chemotherapy, and to identify effective interventions to help prevent mistakes. Chemotherapy errors occur at a rate of about one to four per 1000 orders, affect at least 1 –3% of adult and paediatric oncology patients, and occur at all stages of the medication use process. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Saul N Weingart, Lulu Zhang, Megan Sweeney, Michael Hassett Tags: Series Source Type: research

[Articles] 3 versus 6 months of adjuvant oxaliplatin-fluoropyrimidine combination therapy for colorectal cancer (SCOT): an international, randomised, phase 3, non-inferiority trial
In the whole study population, 3 months of oxaliplatin-containing adjuvant chemotherapy was non-inferior to 6 months of the same therapy for patients with high-risk stage II and stage III colorectal cancer and was associated with reduced toxicity and improved quality of life. Despite the fact the study was underpowered, these data suggest that a shorter duration leads to similar survival outcomes with better quality of life and thus might represent a new standard of care. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Timothy J Iveson, Rachel S Kerr, Mark P Saunders, Jim Cassidy, Niels Henrik Hollander, Josep Tabernero, Andrew Haydon, Bengt Glimelius, Andrea Harkin, Karen Allan, John McQueen, Claire Scudder, Kathleen Anne Boyd, Andrew Briggs, Ashita Waterston, Louise M Tags: Articles Source Type: research

[Perspectives] The rise and fall of the wellness warriors
In 2009, Belle Gibson was diagnosed with terminal brain cancer. She only had 4 months left to live. But rather than follow her doctor's advice, Belle bravely rejected the medical establishment and beat her cancer through a rigorous wellness regime of superfoods, natural medicine, and Gerson therapy (coffee enemas, hourly raw juice, and an organic, vegetarian diet). After a few years, she remained healthy and beautiful and had amassed over 200  000 followers on Instagram. She learnt to code and created a wellness app to promote the diet that saved her life, which became one of the flagship apps for Apple's new smart-watch...
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Robert Stirrups Tags: Perspectives Source Type: research

[Perspectives] Opportunities for improving oncology care
Do you want to see my Fitbit dashboard with my heart rate and number of steps the past week? Can I talk to you on Skype or FaceTime so you can see my rash? Is there a mobile app I can use for exercise or meditation? When Charlotte, aged 56 years, came back for her long-term follow-up visit 2 years after her haematopoietic stem cell transplant for acute myeloid leukaemia, she was delighted that she had passed this major hurdle without a recurrence. She had prepared for her appointment by looking at transplant websites for different problems survivors can have, reading papers on graft versus host disease rash, and making a l...
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Karen L Syrjala Tags: Perspectives Source Type: research

[Perspectives] Slogans and donor pages of cancer centres: do they convey discordant messages?
Slogans are essential to the identity of a brand and help the brand communicate with its audience. Although associated with commercial products, slogans are often used by hospitals and cancer centres as part of a marketing strategy. Cancer centre expenditure on advertising has increased in recent years. Within the small body of scientific literature examining cancer centre advertising, data are scarce on the use of cancer centre slogans. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Ezra Hahn, Dan Ariely, Ian Tannock, Anthony Fyles, Benjamin W Corn Tags: Perspectives Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 510 –20
Maio M, Lewis K, Demidov L, et al. Adjuvant vemurafenib in resected, BRAFV600 mutation-positive melanoma (BRIM8): a randomised, double-blind, placebo-controlled, multicentre, phase 3 trial. Lancet Oncol 2018; 19: 510 –20—In the Summary, Findings, in the second sentence, the p value should have read p=0·26. The appendix file has also been updated. These corrections have been made to the online version as of March 28, 2018, and the printed version is correct. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 474 –85
De Placido S, Gallo C, De Laurentiis M, et al. Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial. Lancet Oncol 2018; 19: 474 –85—In the authors' list, Carmen Mocerino should have been Carmela Mocerino. This correction has been made to the online version as of March 28, 2018, and the printed version is correct. Additionally, the supplementary appendix of this Article has been corrected as of March 28, 2018. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 434 –36
Curigliano G. Addition of platinum salts to neoadjuvant chemotherapy in triple-negative breast cancer: a new standard of care? Lancet Oncol 2018; 19: 434 –36—In this Comment, the bracketed text in the third sentence of the first paragraph should have read, “(168 [53%] of 316 patients vs 49 [31%] of 158 patients, p (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2018; 19: 295 –309
de Boer SM, Powell ME, Mileshkin L, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol 2018; 19: 295 –309—In this Article, the Open Access licence has been changed from CC-BY-NC-ND to CC BY. This correction has been made to the online version as of March 28,2018. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2017; 18: 1221 –37
Lacas B, Bourhis J, Overgaard J, et al. Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol 2017; 18: 1221 –37—In this Article, a change has been made to the authorship. Adam S Garden has been replaced by Beth Beadle in the authorship list. Beth Beadle has also been added to the investigator list in the supplementary appendix. These corrections have been made to the online version as of March 28, 201 8. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Corrections] Correction to Lancet Oncol 2013; 14: 1067 –76
Sgroi DC, Sestak I, Cuzick J, et al. Prediction of late distant recurrence in patients with oestrogen-receptor-positive breast cancer: a prospective comparison of the breast-cancer index (BCI) assay, 21-gene recurrence score, and IHC4 in the TransATAC study population. Lancet Oncol 2013; 14: 1067 –76—In this Article, the 95% CI curves in figure 3, and the graphs on appendix p 7 and p 10, were found to have been calculated using an incorrect statistical method, and as such the width of the CI lines (not the risk curves) needed to be corrected. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research

[Correspondence] Genetic testing for young women with breast cancer – Authors' reply
It is clear both from our data and that of Kelly Metcalfe and colleagues that long-term survivors of breast cancer with BRCA mutations will probably benefit from bilateral mastectomy.1,2 However, patients will only benefit from avoiding a future primary breast cancer if they survive their first diagnosis. (Source: The Lancet Oncology)
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Diana M Eccles, Ellen R Copson Tags: Correspondence Source Type: research

[Correspondence] Genetic testing for young women with breast cancer
Ellen Copson and colleagues1 reported on the effect of carrying a BRCA1 or BRCA2 mutation on survival in a cohort of young women with breast cancer. They did genetic testing on 2733 patients with breast cancer in the Prospective Outcomes in Sporadic versus Hereditary breast cancer (POSH) cohort in the UK and found 12% carried a BRCA1 or BRCA2 mutation. At 10 years, survival of BRCA carriers and non-carriers was not significantly different. Copson and colleagues did not find a significant protective effect of bilateral mastectomy on breast cancer death after a mean follow-up of 8 ·2 years; however, only 21 (6·...
Source: The Lancet Oncology - March 29, 2018 Category: Cancer & Oncology Authors: Kelly Metcalfe, Mohammad R Akbari, Steven A Narod Tags: Correspondence Source Type: research