Improved Detection of Circulating Epithelial Cells in Patients with Intraductal Papillary Mucinous Neoplasms
(Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Joseph W. Franses, Omer Basar, Abdurrahman Kadayifci, Osman Yuksel, Melissa Choz, Anupriya S. Kulkarni, Eric Tai, Kevin D. Vo, Kshitu S. Arora, Niyati Desai, Joseph A. Licausi, Mehmet Toner, Shyamala Maheswaran, Daniel A. Haber, David P. Ryan, William R. Tags: Erratum Source Type: research

Outcomes of Elderly Patients with Advanced Soft Tissue Sarcoma Treated with First‐Line Chemotherapy: A Pooled Analysis of 12 EORTC Soft Tissue and Bone Sarcoma Group Trials
AbstractBackground.Almost half of patients diagnosed with soft tissue sarcoma (STS) are older than 65 years; however, the outcomes of elderly patients with metastatic disease are not well described.Patients and Methods.An elderly cohort of patients aged ≥65 years was extracted from the European Organization for Research and Treatment of Cancer (EORTC) Soft Tissue and Bone Sarcoma Group database of patients treated with first‐line chemotherapy for advanced STS within 12 EORTC clinical trials. Endpoints were overall survival (OS), progression‐free survival (PFS), and response rate (RR).Results.Of 2,810 participants in...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Eugenie Younger, Saskia Litiere, Axel Le Cesne, Olivier Mir, Hans Gelderblom, Antoine Italiano, Sandrine Marreaud, Robin Lewis Jones, Alessandro Gronchi, Winette T.A. van der Graaf Tags: Sarcomas, Geriatric Oncology Source Type: research

At What Cost to Clinical Trial Enrollment? A Retrospective Study of Patient Travel Burden in Cancer Clinical Trials
This study examines the burden of travel from home to cancer center for clinical trial (CT) enrollees.Materials and Methods.Patients from the University of California San Francisco Clinical Trial Management System database who enrolled in a cancer CT for a breast, genitourinary, or gastrointestinal malignancy between 1993 and 2014 were included. Cancer type, household zip code, race/ethnicity, phase of study, study sponsor, and year of signed consent were exported. Distance traveled from home to center was calculated using a GoogleMaps application programming interface. The relationships of distance with phase of CT, house...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Hala T. Borno, Li Zhang, Adam Siegel, Emily Chang, Charles J. Ryan Tags: Health Outcomes and Economics of Cancer Care Source Type: research

Incidence of Thyroid Function Test Abnormalities in Patients Receiving Immune‐Checkpoint Inhibitors for Cancer Treatment
Conclusion.The incidence of TFTAs with ICI therapy was higher than previously reported. Patients with baseline TFTAs and/or who were receiving ipilimumab and nivolumab combination therapy had a higher incidence of TFTAs than patients receiving single‐agent ICI therapy. We recommend more frequent evaluation of thyroid function in the first 8 weeks, especially in patients with baseline TFTAs.Implications for Practice.Increased use of immune‐checkpoint inhibitors in cancer treatment has highlighted the importance of monitoring for and treating immune‐related adverse events. This study was conducted to assess the inciden...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Nisha Subhash Patel, Anais Oury, Gregory A. Daniels, Lyudmila Bazhenova, Sandip Pravin Patel Tags: Symptom Management and Supportive Care, Endocrinology Source Type: research

Pattern and Predictors of Outpatient Palliative Care Referral Among Thoracic Medical Oncologists
Conclusion.The pattern of referral to outpatient palliative care varied widely among thoracic oncologists. Younger oncologists were not only referring a higher proportion of patients, but also referring patients earlier in the disease trajectory.Implications for Practice.This retrospective cohort study found that younger thoracic medical oncologists were significantly more likely to refer patients to outpatient palliative care and to do so earlier in the disease trajectory compared with older oncologists, even after adjusting for other known predictors such as patient demographics. The findings highlight the role of educat...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: David Hui, Kelly Kilgore, Minjeong Park, Diane Liu, Yu Jung Kim, Ji Chan Park, Frank Fossella, Eduardo Bruera Tags: Symptom Management and Supportive Care, Health Outcomes and Economics of Cancer Care Source Type: research

Prognostic Understanding at Diagnosis and Associated Factors in Patients with Advanced Lung Cancer and Their Caregivers
Conclusion.Substantial proportions of advanced lung cancer patients and their caregivers misunderstood their prognosis. Interventions to improve their accurate prognostic understanding should be developed with careful attention paid to its associated factors.Implications for Practice.This study demonstrated that substantial proportions of patients with newly diagnosed advanced lung cancer and their caregivers had misunderstandings about their prognosis. Accurate perceptions of prognosis, which are indispensable in the delivery of effective care, were associated with elevated levels of anxiety and depression in both patient...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Takashi Sato, Kenzo Soejima, Daisuke Fujisawa, Mari Takeuchi, Daisuke Arai, Ichiro Nakachi, Katsuhiko Naoki, Ichiro Kawada, Hiroyuki Yasuda, Kota Ishioka, Shigenari Nukaga, Keigo Kobayashi, Katsunori Masaki, Takashi Inoue, Kota Hikima, Morio Nakamura, Kei Tags: Lung Cancer, Symptom Management and Supportive Care Source Type: research

Prognostic Factors and Efficacy of First‐Line Chemotherapy in Patients with Advanced Thymic Carcinoma: A Retrospective Analysis of 286 Patients from NEJ023 Study
Conclusion.The efficacy of each first‐line chemotherapy regimen for advanced thymic carcinoma did not vary significantly. Our results might support the adequacy of the use of carboplatin/paclitaxel as first‐line chemotherapy for these patients.Implications for Practice.Because of its rarity, there is limited information about prognostic factors and efficacy of chemotherapy in patients with advanced thymic carcinoma. This is the largest data set for those patients treated with chemotherapy. This study suggests there is no significant difference in efficacy between carboplatin/paclitaxel and cisplatin/doxorubicin/vincris...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Ryo Ko, Takehito Shukuya, Yusuke Okuma, Kazunari Tateishi, Hisao Imai, Shunichiro Iwasawa, Eisaku Miyauchi, Akiko Fujiwara, Tomohide Sugiyama, Keisuke Azuma, Keiko Muraki, Masahiro Yamasaki, Hisashi Tanaka, Yuta Takashima, Sayo Soda, Osamu Ishimoto, Nobuy Tags: Lung Cancer, Symptom Management and Supportive Care Source Type: research

Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors for Central Nervous System Metastases from Non‐Small Cell Lung Cancer
AbstractCentral nervous system (CNS) metastases are a common complication in patients with epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC), resulting in a poor prognosis and limited treatment options. Treatment of CNS metastases requires a multidisciplinary approach, and the optimal treatment options and sequence of therapies are yet to be established. Many systemic therapies have poor efficacy in the CNS due to the challenges of crossing the blood‐brain barrier (BBB), creating a major unmet need for the development of agents with good BBB‐penetrating biopharmaceutical properties....
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Manmeet S. Ahluwalia, Kevin Becker, Benjamin P. Levy Tags: Lung Cancer, Neuro-Oncology Source Type: research

Global Acceptance of Biosimilars: Importance of Regulatory Consistency, Education, and Trust
AbstractGlobally, biosimilars are expected to have a key role in improving patient access to biological therapies and addressing concerns regarding the escalating cost of health care. Indeed, in Europe, increased use of biologics and reduced drug prices have been observed after the introduction of biosimilars. Recently, several monoclonal antibody biosimilars of anticancer therapies have been approved, and numerous others are in various stages of clinical development. Biosimilars are authorized via a regulatory pathway separate from that used for generic drugs; they are also regulated separately from novel biologics. Biosi...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Eduardo Cazap, Ira Jacobs, Ali McBride, Robert Popovian, Karol Sikora Tags: New Drug Development and Clinical Pharmacology, Regulatory Issues: FDA, Health Outcomes and Economics of Cancer Care, Global Health and Cancer Source Type: research

Trifluridine/Tipiracil (TAS‐102) in Refractory Metastatic Colorectal Cancer: A Multicenter Register in the Frame of the Italian Compassionate Use Program
Conclusion.One out of five patients achieves clinical benefit with TAS‐102. ECOG PS, LDH, and time from diagnosis of metastatic disease may help to identify these patients. Excluding patients with very short life expectancy appears a reasonable approach.Implications for Practice.Improving the cost‐efficacy ratio of TAS‐102 in metastatic colorectal cancer is needed to spare useless toxicities in a definitely palliative setting. Eastern Cooperative Oncology Group performance status, lactate dehydrogenase levels, and time from the diagnosis of metastatic disease may help to identify patients more likely to achieve benef...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Chiara Cremolini, Daniele Rossini, Erika Martinelli, Filippo Pietrantonio, Sara Lonardi, Silvia Noventa, Emiliano Tamburini, Giovanni Luca Frassineti, Stefania Mosconi, Federico Nichetti, Sabina Murgioni, Teresa Troiani, Beatrice Borelli, Gemma Zucchelli, Tags: Review, Breast Cancer Gastrointestinal Cancer Source Type: research

Immuno‐Oncology Biomarkers for Gastric and Gastroesophageal Junction Adenocarcinoma: Why PD‐L1 Testing May Not Be Enough
Conclusion.PD‐L1 testing alone fails to detect patients who may benefit from ICI. Lower PD‐L1 thresholds and TML testing should be considered in future clinical trials.Implications for Practice.Pembrolizumab is approved by the U.S. Food and Drug Administration for patients with refractory gastric and gastroesophageal cancers if the tumor and adjacent tissue stain positively for the programmed cell death ligand 1 (PD‐L1) protein by companion diagnostic testing. Tumor mutational load, microsatellite instability (MSI), and alternative PD‐L1 testing thresholds may serve as predictive biomarkers for response to immune c...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Benjamin A. Weinberg, Joanne Xiu, Jimmy J. Hwang, Anthony F. Shields, Mohamed E. Salem, John L. Marshall Tags: Precision Medicine, Gastrointestinal Cancer Source Type: research

Developing a Roadmap for Interventional Oncology
This report focuses on current interventional procedures and techniques with a look toward future improvements that will improve cancer care and patient outcomes. (Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Stefan O. Schoenberg, Ulrike I. Attenberger, Stephen B. Solomon, Ralph Weissleder Tags: Cancer Imaging, Cancer Diagnostics and Molecular Pathology Source Type: research

Adjuvant Anthracyclines in Breast Cancer: What Is Their Role?
This article provides an update of data that help inform clinicians of the role anthracyclines should play in adjuvant breast cancer therapy. Two recently reported large randomized trials—the Anthracycline in Early Breast Cancer and Western German Study Plan B studies—compared a taxane and cyclophosphamide regimen with an anthracycline, taxane, and cyclophosphamide regimen. Although the studies had conflicting results, together these studies suggest that the benefit of adjuvant anthracycline therapy over a nonanthracycline taxane‐containing regimen is modest at best and may be primarily seen in patients with ...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Ami N. Shah, William J. Gradishar Tags: Review, Breast Cancer Source Type: research

Pretreatment 18F‐FDG Uptake Heterogeneity Predicts Treatment Outcome of First‐Line Chemotherapy in Patients with Metastatic Triple‐Negative Breast Cancer
AbstractBackground.Intratumoral heterogeneity of 18F‐fluorodeoxyglucose (18F‐FDG) uptake in primary tumor has proven to be a surrogate marker for predicting treatment outcome in various tumors. However, the value of intraindividual heterogeneity in metastatic diseases remains unknown. The aim of this study was to evaluate pretreatment positron emission tomography/computed tomography (PET/CT) 18F‐FDG‐based heterogeneity for the prediction of first‐line treatment outcome in metastatic triple‐negative breast cancer (mTNBC).Materials and Methods.mTNBC patients from three clinical trials (NCT00601159, NCT01287624, a...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Chengcheng Gong, Guang Ma, Xichun Hu, Yingjian Zhang, Zhonghua Wang, Jian Zhang, Yannan Zhao, Yi Li, Yizhao Xie, Zhongyi Yang, Biyun Wang Tags: Radiation Oncology, Breast Cancer, Cancer Imaging Source Type: research

Adjuvant Subcutaneous Trastuzumab for HER2‐Positive Early Breast Cancer: Subgroup Analyses of Safety and Active Medical Conditions by Body Weight in the SafeHer Phase III Study
Conclusion.These data support the use of fixed‐dose H SC as an adjuvant therapy in HER2‐positive EBC and confirm the comparable safety profile of H SC in patients with low body weight or of Asian origin versus the overall population in SafeHer. ClinicalTrials.gov: NCT01566721.Implications for Practice.The safety profile of fixed‐dose subcutaneous trastuzumab (H SC) was comparable between patients in the lowest bodyweight subgroup and the overall patient population, and also between patients of Asian origin (of whom a higher proportion often fall within the lower bodyweight quartiles) and the overall population. The s...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Kyung Hae Jung, Beyhan Ataseven, Mark Verrill, Xavier Pivot, Michelino De Laurentiis, Nedal Al-Sakaff, Sabine Lauer, Mona Shing, Joseph Gligorov, Hamdy A. Azim Tags: Breast Cancer Source Type: research

Selection of Protein Kinase Inhibitors Based on Tumor Tissue Kinase Activity Profiles in Patients with Refractory Solid Malignancies: An Interventional Molecular Profiling Study
Conclusion.Kinase inhibition profiles of multiple PKIs can be reliably determined using fresh tumor biopsies from patients with refractory solid tumors. However, the current in vitro microarray selection approach insufficiently predicted clinical benefit of PKI treatment in these patients. (Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Mariette Labots, Johannes C. Van der Mijn, Henk Dekker, Rita Ruijter, Thang V. Pham, Hans J. Van der Vliet, Jacobus J.M. Van der Hoeven, Gerrit A. Meijer, Henk M.W. Verheul Tags: Chinese Edition, Clinical Trial Results Source Type: research

NGR‐hTNF and Doxorubicin as Second‐Line Treatment of Patients with Small Cell Lung Cancer
Conclusion.NGR‐hTNF plus doxorubicin showed manageable toxicity and promising activity in patients with relapsed SCLC. (Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Vanesa Gregorc, Raffaele Cavina, Sivia Novello, Francesco Grossi, Chiara Lazzari, Enrica Capelletto, Carlo Genova, Giulia Salini, Antonio Lambiase, Armando Santoro Tags: Lung Cancer, Chinese Edition, Clinical Trial Results Source Type: research

EML4‐ALK Rearrangement and Its Therapeutic Implications in Inflammatory Myofibroblastic Tumors
AbstractWith the advent of precision medicine, medical oncology is undergoing a transcendental change. These molecular studies have allowed us to learn about potential targeted therapies for patients with advanced cancers. Perhaps the best‐known example of success in precision medicine is chronic myeloid leukemia and its response to tyrosine kinase inhibitors targeting the BCR‐ABL kinase. Since that original discovery, the role of molecular therapeutics has expanded, and it now presents us with treatment options for common malignancies and rare atypical tumors. In this article, we present a case of a 61‐year‐old fe...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Fernando Vargas-Madueno, Edwin Gould, Raul Valor, Nhu Ngo, Linsheng Zhang, Miguel A. Villalona-Calero Tags: Sarcomas, Precision Medicine, Cancer Diagnostics and Molecular Pathology Precision Medicine Clinic: Molecular Tumor Board Source Type: research

A Case of Nivolumab‐Induced Bullous Pemphigoid: Review of Dermatologic Toxicity Associated with Programmed Cell Death Protein‐1/Programmed Death Ligand‐1 Inhibitors and Recommendations for Diagnosis and Management
Immunotherapy has emerged as a highly effective treatment for numerous cancers. Use of checkpoint inhibitors against various molecules including programmed cell death protein‐1 (PD‐1), programmed death ligand‐1 (PD‐L1), and cytotoxic T‐lymphocyte‐associated protein‐4 have become widespread in clinical practice. Compared with conventional chemotherapy, immunotherapy is associated with a unique set of immune reactions known collectively as immune‐related adverse events (irAEs). Of known irAEs, cutaneous toxicity is among the most frequently observed in patients treated with immunotherapy. Although often mild,...
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Adriana T. Lopez, Larisa Geskin Tags: Symptom Management and Supportive Care, Precision Medicine Immune ‐ Related Adverse Events Source Type: research

In Reply
(Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Joseph W. Franses, David T. Ting Tags: Cancer Diagnostics and Molecular Pathology Letters to the Editor Source Type: research

Regarding “Improved Detection of Circulating Epithelial Cells in Patients with Intraductal Papillary Mucinous Neoplasms”
(Source: The Oncologist)
Source: The Oncologist - October 12, 2018 Category: Cancer & Oncology Authors: Go J. Yoshida Tags: Precision Medicine, Cancer Diagnostics and Molecular Pathology Letters to the Editor Source Type: research

Magnetic Resonance Imaging-Based Screening for Asymptomatic Brain Tumors: A Review.
Abstract Brain tumors comprise 2% of all cancers but are disproportionately responsible for cancer-related deaths. The 5-year survival rate of glioblastoma, the most common form of malignant brain tumor, is only 4.7%, and the overall 5-year survival rate for any brain tumor is 34.4%. In light of the generally poor clinical outcomes associated with these malignancies, there has been interest in the concept of brain tumor screening through magnetic resonance imaging. Here, we will provide a general overview of the screening principles and brain tumor epidemiology, then highlight the major studies examining brain tum...
Source: The Oncologist - October 10, 2018 Category: Cancer & Oncology Authors: Neugut AI, Sackstein P, Hillyer GC, Jacobson JS, Bruce J, Lassman AB, Stieg PA Tags: Oncologist Source Type: research

A Prospective Trial Evaluating the Safety of a Shortened Infusion of Ramucirumab in Patients with Gastrointestinal Cancer.
CONCLUSION: For patients without development of IRRs upon the first ramucirumab administration, shortening infusion time (from 60 to 20 minutes) is safe and feasible. PMID: 30305415 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - October 10, 2018 Category: Cancer & Oncology Authors: Hashimoto N, Mitani S, Taniguchi H, Narita Y, Kato K, Masuishi T, Kadowaki S, Onishi S, Tajika M, Takahashi S, Shimomura K, Takahata C, Hotta E, Kobara M, Muro K Tags: Oncologist Source Type: research

In Reply.
PMID: 30305416 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - October 10, 2018 Category: Cancer & Oncology Authors: Franses JW, Ting DT Tags: Oncologist Source Type: research

Clinical Benefit to an Aurora A Kinase Inhibitor in a Patient with Metastatic Integrase Interactor 1-Deficient Carcinoma.
This report describes a 30-year-old woman with INI-1-deficient carcinoma who progressed on combination chemotherapy and an EZH2 inhibitor. Next-generation-sequencing-based targeted cancer-related gene assay confirmed SMARCB1 loss and revealed other mutations in breast cancer 1 gene and checkpoint kinase 2 gene, which may have impacted her clinical course. After discussion at the molecular tumor board, she was offered alisertib, an aurora A kinase inhibitor, on a single-patient expanded-use program and achieved prolonged disease stabilization. Aurora A kinase inhibition may have an important role in the management of patien...
Source: The Oncologist - October 8, 2018 Category: Cancer & Oncology Authors: Karantanos T, Rooper L, Kang Y, Lin CT, Wenga P, Sagorsky S, Lauring J, Kang H Tags: Oncologist Source Type: research

Phase I/II Trial of Vandetanib and Bortezomib in Adults with Locally Advanced or Metastatic Medullary Thyroid Cancer.
CONCLUSION: The MTD of the combination was established as bortezomib, 1.3 mg/m2 IV days 1, 4, 8, and 11 with vandetanib 300 mg p.o. daily. RECIST responses were observed in patients with a diagnosis of MTC. PMID: 30297385 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - October 8, 2018 Category: Cancer & Oncology Authors: Del Rivero J, Edgerly M, Ward J, Madan RA, Balasubramaniam S, Fojo T, Gramza AW Tags: Oncologist Source Type: research

Indirect Evaluation of Bone Saturation with Zoledronic Acid After Long-Term Dosing.
CONCLUSION: Long-term ZA treatment may not impact bone saturation, and ZA dosing frequency does not seem to influence drug retention rates. IMPLICATIONS FOR PRACTICE: Zoledronic acid (ZA), used along with standard antineoplastic therapy to treat bone metastases associated with solid tumors and multiple myeloma, requires frequent (every 3-4 or every 12 weeks) long-term administration. This may result in bone saturation and subsequently lead to a higher risk of adverse events such as osteonecrosis of the jaw and atypical fractures. This post hoc analysis used surrogate markers to demonstrate that prolonged ZA administra...
Source: The Oncologist - October 8, 2018 Category: Cancer & Oncology Authors: Hortobagyi GN, Zheng M, Mohanlal R Tags: Oncologist Source Type: research

A Randomized Phase II Trial (TAMIGA) Evaluating the Efficacy and Safety of Continuous Bevacizumab Through Multiple Lines of Treatment for Recurrent Glioblastoma.
CONCLUSION: There was no survival benefit and no detriment observed with continuing BEV through multiple lines in patients with recurrent glioblastoma. IMPLICATIONS FOR PRACTICE: Previous research suggested that there may be value in continuing bevacizumab (BEV) beyond progression through multiple lines of therapy. No survival benefit was observed with the use of BEV through multiple lines in patients with glioblastoma who had progressed after first-line treatment (radiotherapy + temozolomide + BEV). No new safety concerns arose from the use of BEV through multiple lines of therapy. PMID: 30266892 [PubMed - as su...
Source: The Oncologist - September 28, 2018 Category: Cancer & Oncology Authors: Brandes AA, Gil-Gil M, Saran F, Carpentier AF, Nowak AK, Mason W, Zagonel V, Dubois F, Finocchiaro G, Fountzilas G, Cernea DM, Chinot O, Anghel R, Ghiringhelli F, Beauchesne P, Lombardi G, Franceschi E, Makrutzki M, Mpofu C, Urban HJ, Pichler J Tags: Oncologist Source Type: research

A Patient-Reported Outcome Instrument to Assess Symptom Burden and Predict Survival in Patients with Advanced Cancer: Flipping the Paradigm to Improve Timing of Palliative and End-of-Life Discussions and Reduce Unwanted Health Care Costs.
Discussions and Reduce Unwanted Health Care Costs. Oncologist. 2018 Sep 28;: Authors: Goldberg SL, Paramanathan D, Khoury R, Patel S, Jagun D, Arunajadai S, DeVincenzo V, Benito RP, Gruman B, Kaur S, Paddock S, Norden AD, Schultz EV, Hervey J, Jordan T, Goy A, Pecora AL Abstract BACKGROUND: Discussions regarding palliative care and end-of-life care issues are frequently delayed past the time of usefulness, resulting in unwanted medical care. We sought to develop a patient-reported outcome (PRO) instrument that allows patients to voice their symptom burdens and facilitate timing of discussions. SU...
Source: The Oncologist - September 28, 2018 Category: Cancer & Oncology Authors: Goldberg SL, Paramanathan D, Khoury R, Patel S, Jagun D, Arunajadai S, DeVincenzo V, Benito RP, Gruman B, Kaur S, Paddock S, Norden AD, Schultz EV, Hervey J, Jordan T, Goy A, Pecora AL Tags: Oncologist Source Type: research

A Longitudinal Study of the Association of Clinical Indices of Cardiovascular Autonomic Function with Breast Cancer Treatment and Exercise Training.
CONCLUSION: In this study, chemotherapy resulted in increased HRrest and tachycardia, as well as decreased blood pressure and hypotension. Anthracyclines, trastuzumab, and left-sided radiation were associated with HRrest elevations and impairments of HRrecovery, but exercise training at least twice a week appeared to mitigate these changes. IMPLICATIONS FOR PRACTICE: This study characterized changes in clinically accessible measures with well-established prognostic value for cardiovascular disease, and investigated associations with cardiotoxic treatments and the positive influence of exercise. The chemotherapy-relate...
Source: The Oncologist - September 26, 2018 Category: Cancer & Oncology Authors: Kirkham AA, Lloyd MG, Claydon VE, Gelmon KA, McKenzie DC, Campbell KL Tags: Oncologist Source Type: research

Cost-Effectiveness of Osimertinib in Treating Newly Diagnosed, Advanced EGFR-Mutation-Positive Non-Small Cell Lung Cancer.
CONCLUSION: Osimertinib as first-line treatment could gain more health benefits in comparison with standard EGFR-TKIs or second-line use of osimertinib. However, because of the high cost of treatment, the cost-effectiveness analyses were not in favor of the first-line use of osimertinib from a public payer's perspective in the U.S. and China. IMPLICATIONS FOR PRACTICE: Osimertinib as first-line treatment yielded the greatest health outcomes but is not a cost-effective strategy for lung cancer in the U.S. and China. The price of osimertinib has a substantial impact on economic outcomes. PMID: 30257889 [PubMed - as...
Source: The Oncologist - September 26, 2018 Category: Cancer & Oncology Authors: Wu B, Gu X, Zhang Q, Xie F Tags: Oncologist Source Type: research

Venous Thromboembolism in Patients with Sarcoma: A Retrospective Study.
CONCLUSION: VTE is not infrequent in patients with sarcoma. Adoption of common guidelines for cancer-associated thrombosis is recommended. PMID: 30257890 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - September 26, 2018 Category: Cancer & Oncology Authors: Alcindor T, Al-Fakeeh A, Goulding K, Solymoss S, Ste-Marie N, Turcotte R Tags: Oncologist Source Type: research

Prognostic Nomogram Based on Histological Characteristics of Fibrotic Tumor Stroma in Patients Who Underwent Curative Resection for Intrahepatic Cholangiocarcinoma.
CONCLUSION: Immature FTS was an independent risk factor for survival and was associated with sparser CD3 and CD8 positive TILs in ICC. The prognostic nomogram integrating the maturity of FTS offers a more accurate risk stratification for postoperative ICC patients. IMPLICATIONS FOR PRACTICE: Accumulating evidence has suggested that fibrotic components in tumor microenvironment (TME) play a complicated and vital role in TME reprogramming and cancer progression. However, in clinical practice, the evaluation of fibrotic tumor stroma (FTS) is still neglected to some extent. This study's findings indicated that, in intrahe...
Source: The Oncologist - September 26, 2018 Category: Cancer & Oncology Authors: Jing CY, Fu YP, Huang JL, Zhang MX, Yi Y, Gan W, Xu X, Shen HJ, Lin JJ, Zheng SS, Zhang J, Zhou J, Fan J, Ren ZG, Qiu SJ, Zhang BH Tags: Oncologist Source Type: research

Cosmetic Consequences of Breast-Conserving Treatment for Breast Cancer: Something Worth Talking About.
CONCLUSION: Breast cancer patients have a need for long-term attention for cosmetic outcome of BCT, which should be tailored during the treatment and follow-up process. IMPLICATIONS FOR PRACTICE: Currently, no literature exists concerning patients' needs for information regarding the cosmetic effects of breast-conserving therapy (BCT). Bringing up the cosmetic effects of BCT by health care professionals does not appear to be a standard part of treatment and follow-up. It is expected that the quality of care and life will be improved by providing information and guidance regarding the cosmetic outcome of BCT within the...
Source: The Oncologist - September 26, 2018 Category: Cancer & Oncology Authors: Brands-Appeldoorn A, Maaskant-Braat S, Schenk K, Roumen R Tags: Oncologist Source Type: research

Perceptions of Oncologists About Sharing Clinic Notes with Patients.
Abstract In a large survey (n = 809) conducted to understand how oncologists differ from nononcologists regarding routinely sharing visit notes with patients, oncologists were less likely to agree patient safety would improve (p = .03) or that patients would be offended after reading notes (p = .01); however, they agreed with nononcologists that sharing notes would lead to less candid documentation (69% vs. 73%; p = .39). Oncologists share a high level of worry about the impact of sharing notes on documentation practices, a concern that will need to be addressed as the practice of sharing visit notes expands to ca...
Source: The Oncologist - September 25, 2018 Category: Cancer & Oncology Authors: McCleary NJ, Healey MJ, Weng S, Song AB, Lederman RI, Ramelson HZ, Wagner AJ, Abel GA Tags: Oncologist Source Type: research

Response to Oral Immediate-Release Opioids for Breakthrough Pain in Patients with Advanced Cancer with Adequately Controlled Background Pain.
CONCLUSION: The vast majority of patients with advanced cancer with adequately controlled background pain reported a good response to oral IR opioids for BTP, supporting their use in clinical practice. IMPLICATIONS FOR PRACTICE: Oral immediate-release opioids are standard treatment for cancer breakthrough pain. However, information regarding treatment response to these commonly used opioids is limited. This study provides information that the vast majority of patients with advanced cancer, with adequately controlled background pain, reported good response to oral immediate release opioids for managing their breakthrou...
Source: The Oncologist - September 25, 2018 Category: Cancer & Oncology Authors: Azhar A, Kim YJ, Haider A, Hui D, Balankari VR, Epner MC, Park M, Liu DD, Williams J, Frisbee-Hume SE, Allo JA, Bruera E Tags: Oncologist Source Type: research

Anticancer Agent-Induced Life-Threatening Skin Toxicities: A Database Study of Spontaneous Reporting Data.
Abstract Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially life-threatening cutaneous and mucosal adverse reactions to drugs. Nevertheless, the connection to anticancer agents remains unclear. To provide insight into the association of such adverse reactions with anticancer agents, we analyzed the profile of anticancer agent-induced SJS and TEN in the Japanese population. Of the 9,738 SJS/TEN events recorded in a database of spontaneous reporting data, 485 (5%, further categorized as SJS, 384 events, 79%; TEN, 101 events, 21%) were identified as anticancer agent-induced, and 53 of...
Source: The Oncologist - September 25, 2018 Category: Cancer & Oncology Authors: Tanaka R, Yonemori K, Hirakawa A, Kinoshita F, Kobayashi Y, Yamazaki N, Fujimoto M, Tamura K, Fujiwara Y Tags: Oncologist Source Type: research

A Phase II Trial of Pazopanib in Patients with Metastatic Alveolar Soft Part Sarcoma.
CONCLUSION: Pazopanib showed modest antitumor activity with manageable toxicities for patients with metastatic ASPS. PMID: 30254189 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - September 25, 2018 Category: Cancer & Oncology Authors: Kim M, Kim TM, Keam B, Kim YJ, Paeng JC, Moon KC, Kim DW, Heo DS Tags: Oncologist Source Type: research

“Hey Mom, Now I'm Officially an Oncologist”
(Source: The Oncologist)
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Tarek Assi Tags: Narratives in Oncology, Symptom Management and Supportive Care, Medical Ethics Source Type: research

Families’ Sense of Abandonment When Patients Are Referred to Hospice
This study aimed to clarify the prevalence of families’ sense of abandonment, explore the association between the sense of abandonment and the oncologists’ behaviors, and investigate the association between the sense of abandonment and the families’ depression and complicated grief.Patients and Methods.This was part of a nationwide self‐reported questionnaire survey of bereaved families of patients with cancer who died in inpatient hospices. We sent questionnaires to 947 bereaved families of patients with cancer who died in 133 certified hospices between May 2012 and January 2014.Results.Among 707 respo...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Takuya Odagiri, Tatsuya Morita, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita, J-HOPE Group Tags: Symptom Management and Supportive Care Source Type: research

FDA Approval Summary: Mylotarg for Treatment of Patients with Relapsed or Refractory CD33‐Positive Acute Myeloid Leukemia
AbstractOn September 2, 2017, the U.S. Food and Drug Administration approved gemtuzumab ozogamicin (GO; Mylotarg; Pfizer, New York City, NY) for treatment of relapsed or refractory (R/R) CD33‐positive acute myeloid leukemia (AML) in patients 2 years of age and older. GO is a CD33‐directed antibody drug conjugate linked to the cytotoxic antibiotic calicheamicin. It originally received accelerated approval for treatment of older patients with relapsed CD33‐positive AML in 2000, but it was withdrawn from the market in 2010 when the confirmatory trial failed to demonstrate clinical benefit among safety concerns, such as ...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Kelly J. Norsworthy, Chia-Wen Ko, Jee Eun Lee, Jiang Liu, Christy S. John, Donna Przepiorka, Ann T. Farrell, Richard Pazdur Tags: Leukemias, New Drug Development and Clinical Pharmacology, Regulatory Issues: FDA Source Type: research

Genomic Profiling of HER2‐Positive Gastric Cancer: PI3K/Akt/mTOR Pathway as Predictor of Outcomes in HER2‐Positive Advanced Gastric Cancer Treated with Trastuzumab
Conclusion.Our results provide for the first time a detailed molecular profile of concurrent genetic alterations in HER2‐positive AGC. PI3K pathway activation could be used as a predictive marker of worse outcome in this patient population. In addition, gains in copy number of other TKR genes in this subgroup may also influence the survival benefit obtained with trastuzumab.Implications for Practice.This article reports, for the first time, a detailed molecular profile of genomic alterations in patients with HER2‐positive advanced gastric cancer (AGC). PI3K/Akt/mTOR signaling pathway activation seems to have a differen...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Asuncion Diaz-Serrano, Barbara Angulo, Carolina Dominguez, Roberto Pazo-Cid, Antonieta Salud, Paula Jimenez-Fonseca, Ana Leon, Maria Carmen Galan, Maria Alsina, Fernando Rivera, J. Carlos Plaza, Luis Paz-Ares, Fernando Lopez-Rios, Carlos Gomez-Martin Tags: Gastrointestinal Cancer Source Type: research

Outcome of Mismatch Repair‐Deficient Metastatic Colorectal Cancer: The Mayo Clinic Experience
AbstractBackground.Deficiencies in the DNA mismatch repair system cause errors during DNA replication, which in turn give rise to microsatellite instability (MSI). The impact of MSI on survival in metastatic colorectal cancer (mCRC) is unclear. This cohort study aims to investigate the prognostic and predictive value of MSI in mCRC prior to the immune therapy era.Materials and Methods.A total of 75 MSI‐high (MSI‐H) mCRC patients (pts) and 75 matched (age, gender, disease sidedness, metachronous/synchronous) microsatellite‐stable (MSS) mCRC pts were identified from 1,268 mCRC pts who had MSI/mismatch repair test resul...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Zhaohui Jin, Cristobal T. Sanhueza, Benny Johnson, David M. Nagorney, David W. Larson, Kristin C. Mara, William C. Harmsen, Thomas C. Smyrk, Axel Grothey, Joleen M. Hubbard Tags: Gastrointestinal Cancer Source Type: research

CheckMate 141: 1‐Year Update and Subgroup Analysis of Nivolumab as First‐Line Therapy in Patients with Recurrent/Metastatic Head and Neck Cancer
AbstractNivolumab significantly improved overall survival (OS) vs investigator's choice (IC) of chemotherapy at the primary analysis of randomized, open‐label, phase 3 CheckMate 141 in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). Here, we report that OS benefit with nivolumab was maintained at a minimum follow‐up of 11.4 months. Further, OS benefit with nivolumab vs IC was also noted among patients who received first‐line treatment for R/M SCCHN after progressing on platinum therapy for locally advanced disease in the adjuvant or primary (i.e., with radiation) sett...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Maura L. Gillison, George Blumenschein Jr., Jerome Fayette, Joel Guigay, A. Dimitrios Colevas, Lisa Licitra, Kevin J. Harrington, Stefan Kasper, Everett E. Vokes, Caroline Even, Francis Worden, Nabil F. Saba, Lara Carmen Iglesias Docampo, Robert Haddad, T Tags: Head and Neck Cancers Brief Communications Source Type: research

Representation of Minorities and Elderly Patients in Multiple Myeloma Clinical Trials
AbstractMultiple myeloma (MM) occurs in all races, but the incidence in non‐Hispanic black patients (NHBs) is two to three times higher than in non‐Hispanic white patients (NHWs). We determined the representation of minorities and elderly patients in MM clinical trials. Enrollment data from all therapeutic trials reported in ClinicalTrials.gov from 2000 to 2016 were analyzed. Enrollment fraction (EF) was defined as the number of trial enrollees divided by the 2014 MM prevalence. Participation in MM clinical trials varied significantly across racial and ethnic groups; NHWs were more likely to be enrolled in clinical tri...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Narȷust Duma, Tariq Azam, Irbaz Bin Riaz, Miguel Gonzalez-Velez, Sikander Ailawadhi, Ronald Go Tags: Myelomas, Geriatric Oncology Brief Communications Source Type: research

Emerging Gene Fusion Drivers in Primary and Metastatic Central Nervous System Malignancies: A Review of Available Evidence for Systemic Targeted Therapies
AbstractPrimary and metastatic tumors of the central nervous system present a difficult clinical challenge, and they are a common cause of disease progression and death. For most patients, treatment consists primarily of surgery and/or radiotherapy. In recent years, systemic therapies have become available or are under investigation for patients whose tumors are driven by specific genetic alterations, and some of these targeted treatments have been associated with dramatic improvements in extracranial and intracranial disease control and survival. However, the success of other systemic therapies has been hindered by inadeq...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Priscilla K. Brastianos, Franziska Maria Ippen, Umbreen Hafeez, Hui K. Gan Tags: Neuro-Oncology ‐ Source Type: research

Role of Epidermal Growth Factor Receptor (EGFR) Inhibitors and Radiation in the Management of Brain Metastases from EGFR Mutant Lung Cancers
AbstractThe growth of genotype‐directed targeted therapies, such as inhibitors of the epidermal growth factor receptor (EGFR), has revolutionized treatment for some patients with oncogene‐addicted lung cancer. However, as systemic control for these patients has improved, brain metastases remain an important source of morbidity and mortality. Traditional treatment for brain metastases has been radiotherapy, either whole‐brain radiation or stereotactic radiosurgery. The growing availability of drugs that can cross the blood‐brain barrier and have activity in the central nervous system (CNS) has led to many studies in...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Melin J. Khandekar, Zofia Piotrowska, Henning Willers, Lecia V. Sequist Tags: Review, Lung Cancer, Neuro-Oncology, Precision Medicine Source Type: research

Recent Advances in the Treatment of Peripheral T‐Cell Lymphoma
AbstractPeripheral T‐cell lymphoma (PTCL) is a heterogeneous group of clinically aggressive diseases associated with poor outcome. Despite progress in the last several years, resulting in a deeper understanding of the natural history and biology of PTCL based on molecular profiling and next‐generation sequencing, there is a need for improvement in efficacy of chemotherapeutic regimens for newly diagnosed patients. Treatment in the front‐line setting is most often cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP‐like regimens, which are associated with a high failure rate and frequent relaps...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Kamel Laribi, Mustapha Alani, Catherine Truong, Alix Baugier de Materre Tags: Lymphoma, Hematologic Malignancies Source Type: research

Lenalidomide in Pretreated Mantle Cell Lymphoma Patients: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice (the Lenamant Study)
Conclusion.Lenalidomide therapy for relapsed MCL patients is effective and tolerable even in a real‐life context.Implication for Practice.Several factors influence treatment choice in relapsed/refractory mantle cell lymphoma (rrMCL), and the therapeutic scenario is continuously evolving. In fact, rrMCL became the first lymphoma for which four novel agents have been approved: temsirolimus, lenalidomide, ibrutinib, and bortezomib. The rrMCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for rrMCL patients is effective and tolerable even in a real...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Vittorio Stefoni, Cinzia Pellegrini, Alessandro Broccoli, Luca Baldini, Monica Tani, Emanuele Cencini, Amalia Figuera, Michela Ansuinelli, Elisa Bernocco, Maria Cantonetti, Maria Christina Cox, Filippo Ballerini, Chiara Rusconi, Carlo Visco, Luca Arcaini, Tags: Lymphoma, Hematologic Malignancies Source Type: research

Cervical Cancer in Ethiopia: The Effect of Adherence to Radiotherapy on Survival
AbstractBackground.Discontinuation of radiotherapy (RT) for cervical cancer (CC) in sub‐Saharan Africa is common because of patient‐ and health service‐related reasons. This analysis describes toxicities and the effect of adherence on survival.Materials and Methods.A total of 788 patients with CC (2008–2012) who received RT at Addis Ababa University Hospital were included. External beam RT without brachytherapy was performed according to local guidelines. We previously described survival and prognostic factors. Now we analyzed adherence and survival according to total doses received. Adjustment via multivariate...
Source: The Oncologist - September 11, 2018 Category: Cancer & Oncology Authors: Ulrike Moelle, Assefa Mathewos, Abreha Aynalem, Tigeneh Wondemagegnehu, Bekuretsion Yonas, Matthias Begoihn, Adamu Addissie, Susanne Unverzagt, Ahmedin Jemal, Christoph Thomssen, Dirk Vordermark, Eva J. Kantelhardt Tags: Gynecologic Oncology, Radiation Oncology, Global Health and Cancer Source Type: research