Role of Resection Following Focal Progression with Standard Doses of Imatinib in Patients with Advanced Gastrointestinal Stromal Tumors: Results of Propensity Score Analyses.
This study aims to compare the clinical outcomes of resection plus imatinib dose escalation or maintenance (S group) with imatinib dose escalation alone (NS group) in patients with advanced GIST following focal progression (FP) with standard doses of imatinib. MATERIALS AND METHODS: A total of 90 patients with advanced GISTs who experienced FP with standard doses of imatinib were included in this retrospective analysis. The primary endpoints were time to imatinib treatment failure (TTF) and overall survival (OS). RESULTS: Compared with the NS group (n = 52), patients in the S group (n = 38) had a higher proportio...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Cho H, Ryu MH, Lee Y, Park YS, Kim KH, Kim JH, Park Y, Lee SM, Kim CW, Kim BS, Yoo MW, Kang YK Tags: Oncologist Source Type: research

Adjuvant Trastuzumab Therapy: Can We Balance Efficacy and Safety?
We describe a potential approach undertaken by our group, and others, and call for a randomized trial. PMID: 31315962 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Barron CC, Tyagi NK, Alhussein MM, Mukherjee SD, Ellis PM, Dhesy-Thind S, Leong DP Tags: Oncologist Source Type: research

Individualized Prediction of Survival Benefit from Postmastectomy Radiotherapy for Patients with Breast Cancer with One to Three Positive Axillary Lymph Nodes.
CONCLUSION: Besides the number of involved nodes, extra variables existed as predictors of survival outcomes in this cohort; therefore, the recommendation of PMRT or no PMRT requires comprehensive consideration. This clinically validated nomogram provided a useful tool that could aid decision making by estimating DSS and OS benefits from PMRT, useful in predicting 5- and 10-year DSS and OS for patients with one to three positive nodes after mastectomy. IMPLICATIONS FOR PRACTICE: This study evaluated population-based data to identify prognostic factors associated with patients with breast cancer with one to three lymph...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Zhang N, Zhang J, Zhang H, Liu Y, Zhao W, Wang L, Chen B, Moran MS, Haffty BG, Yang Q Tags: Oncologist Source Type: research

The Lessons Learned from Patients We Didn't Help
(Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Varun K. Chowdhry Tags: Narratives in Oncology, Radiation Oncology, Health Outcomes and Economics of Cancer Care Source Type: research

Clinical Characteristics and Prognostic Factors of Patients with Intrahepatic Cholangiocarcinoma with Fever: A Propensity Score Matching Analysis
This study retrospectively reviewed 31 patients with ICC with fever (≥38.0°C) treated at our hospital between January 2002 and December 2014. A propensity score was used to match patients with and without fever at a ratio of 1:2.Results.Patients with ICC with fever had higher serum γ‐glutamyl transferase and carcinoembryonic antigen levels, larger tumors, poorer tumor differentiation, and worse prognosis (all p  (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Zi-Jun Gong, Jian-Wen Cheng, Pin-Ting Gao, Ao Huang, Yun-Fan Sun, Kai-Qian Zhou, Bo Hu, Shuang-Jian Qiu, Jian Zhou, Jia Fan, Xin-Rong Yang Tags: Hepatobiliary Source Type: research

Degree of MDM2 Amplification Affects Clinical Outcomes in Dedifferentiated Liposarcoma
Conclusion.MDM2 amplification levels in DDLPS follow a reproducible distribution and are associated with clinical outcomes and drug sensitivity. These results suggest that a prospective study of MDM2 as a predictive biomarker in DDLPS is warranted.Implications for Practice.No validated biomarkers exist for treatment selection in dedifferentiated liposarcoma (DDLPS). Although murine double minute 2 (MDM2) is currently used for diagnosis, the clinical relevance of MDM2 amplification has yet to be fully assessed. This study found that MDM2 amplification follows a predictable distribution in DDLPS and correlates with clinical ...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Kate Lynn J. Bill, Nathan D. Seligson, John L. Hays, Achal Awasthi, Bryce Demoret, Colin W. Stets, Megan C. Duggan, Manojkumar Bupathi, Guy N. Brock, Sherri Z. Millis, Reena Shakya, Cynthia D. Timmers, Paul E. Wakely Jr., Raphael E. Pollock, James L. Chen Tags: Sarcomas Source Type: research

Brain Metastases and Place of Antiangiogenic Therapies in Alveolar Soft Part Sarcoma: A Retrospective Analysis of the French Sarcoma Group
Conclusion.Baseline larger tumors were associated with increased risk of brain metastasis in patients with ASPS. Patients with BM seem to have little benefit from AAT, suggesting the need to develop antineoplastic agents with high central nervous system penetrance in this setting.Implications for Practice.Alveolar soft part sarcoma (ASPS) is an extremely rare subtype of sarcoma that is particularly resistant to conventional therapies. Antiangiogenic therapies (AAT) have shown promising results. However, patients with ASPS still die of tumor evolution. This study highlights the prognostic shift induced by brain metastasis (...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Gabriel G. Malouf, Guillaume Beinse, Julien Adam, Olivier Mir, Ali N. Chamseddine, Philippe Terrier, Charles Honore, Jean-Philippe Spano, Antoine Italiano, Jean-Emmanuel Kurtz, Jean-Michel Coindre, Jean-Yves Blay, Axel Le Cesne Tags: Neuro-Oncology, Sarcomas Source Type: research

BRCA1/2 Functional Loss Defines a Targetable Subset in Leiomyosarcoma
AbstractBackground.Soft‐tissue sarcomas (STS) describe a heterogeneous group of mesenchymal tumors with limited treatment options. Targeted therapies exist for BRCA1/2 gene alterations, but their prevalence and role have not been fully described in STS. Here, we present the largest effort to characterize the frequency of homologous recombination (HR) DNA repair pathway alterations in STS subtypes and highlight the unique nature of leiomyosarcoma (LMS).Materials and Methods.DNA sequencing data were analyzed for HR pathway alterations for 1,236 patients with STS. DNA sequencing data from an additional 1,312 patients were u...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Nathan D. Seligson, Esko A. Kautto, Edward N. Passen, Colin Stets, Amanda E. Toland, Sherri Z. Millis, Christian F. Meyer, John L. Hays, James L. Chen Tags: Sarcomas, Precision Medicine Clinic: Molecular Tumor Board Source Type: research

Adverse Event Management in Patients with BRAF V600E‐Mutant Non‐Small Cell Lung Cancer Treated with Dabrafenib plus Trametinib
AbstractTherapies for advanced non‐small cell lung cancer (NSCLC) continue to become more sophisticated. Chemotherapeutics are giving way to newer approaches such as immune checkpoint inhibitors and targeted therapies for greater efficacy and improved outcomes. Dabrafenib plus trametinib combination therapy was first approved for the treatment of metastatic melanoma harboring the BRAF V600‐mutation in 2014. In 2017, the U.S. Food and Drug Administration approved the combination for patients with NSCLC with the same mutation based on an ≈ 65% response rate and median progression‐free survival of 10–11 mont...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Anna Chalmers, Laura Cannon, Wallace Akerley Tags: Lung Cancer Source Type: research

Outcomes and Toxicities of Programmed Death‐1 (PD‐1) Inhibitors in Hodgkin Lymphoma Patients in the United States: A Real‐World, Multicenter Retrospective Analysis
Conclusion.To our knowledge, this analysis is the first describing real‐world experience with PD‐1i in cHL patients in the U.S. Here, we demonstrate similar response rates compared to prior studies. The toxicity profile of PD‐1i was similar to that seen in previous studies; we further describe toxicity patterns in those with prior autoimmune disease or allogeneic transplant. Post‐PD‐1i systemic therapies appear active. These results support the effectiveness and tolerability of PD‐1i therapy in R/R cHL in a real‐world setting.Implications for Practice.Two PD‐1 inhibitors have recently been approved for pati...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Steven M. Bair, Lauren E. Strelec, Tatyana A. Feldman, Gulrayz Ahmed, Philippe Armand, Nirav N. Shah, Arun N. Singavi, Nishitha Reddy, Nadia Khan, Charalambos Andreadis, Khoan Vu, Scott F. Huntington, Smith Giri, Chaitra Ujjani, Christina Howlett, Malik F Tags: Lymphoma, Hematologic Malignancies Source Type: research

Neoadjuvant FOLFIRINOX for Patients with Borderline Resectable or Locally Advanced Pancreatic Cancer: Results of a Decision Analysis
Conclusion.Our modeling analysis suggests that nFOLFIRINOX is preferable to upfront surgery for patients with BR/LA PDAC from both an effectiveness and cost‐effectiveness standpoint. Additional clinical data that further define the long‐term effectiveness of nFOLFIRINOX are needed to confirm our results.Implications for Practice.Increasingly, neoadjuvant FOLFIRINOX has been used for borderline resectable and locally advanced pancreatic cancer with the goal of rendering them resectable and decreasing risk of recurrence. Despite many efforts to show the benefits of neoadjuvant over adjuvant therapies, clinical evidence t...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Jin G. Choi, Ryan D. Nipp, Angela Tramontano, Ayman Ali, Tiannan Zhan, Pari Pandharipande, Emily C. Dowling, Cristina R. Ferrone, Theodore S. Hong, Deborah Schrag, Carlos Fernandez-Del Castillo, David P. Ryan, Chung Yin Kong, Chin Hur Tags: Health Outcomes and Economics of Cancer Care, Gastrointestinal Cancer Source Type: research

Neoadjuvant Chemotherapy Use for Nonmetastatic Breast Cancer at Five Public South African Hospitals and Impact on Time to Initial Cancer Therapy
Conclusion.NAC use for BC at these South African hospitals was associated with both tumor characteristics and heterogenous resource constraints.Implications for Practice.Using data from a large breast cancer cohort treated in South Africa's public healthcare system, the authors looked at determinants of neoadjuvant chemotherapy use and time to initiate treatment. It was found that neoadjuvant chemotherapy was associated with increasing tumor burden and aggressive molecular subtypes, demonstrating clinically appropriate care in a lower resource setting. Results of this study also showed that time to treatment differences be...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Daniel S. O'Neil, Sarah Nietz, Ines Buccimazza, Urishka Singh, Sharon Čačala, Laura W. Stopforth, Maureen Joffe, Judith S. Jacobson, Alfred I. Neugut, Katherine D. Crew, Paul Ruff, Herbert Cubasch Tags: Breast Cancer, Health Outcomes and Economics of Cancer Care, Global Health and Cancer Source Type: research

Phase II Randomized Trial of Sequential or Concurrent FOLFOXIRI‐Bevacizumab Versus FOLFOX‐Bevacizumab for Metastatic Colorectal Cancer (STEAM)
AbstractBackground.First‐line treatment for metastatic colorectal cancer (mCRC) typically entails a biologic such as bevacizumab (BEV) with 5‐fluorouracil/leucovorin/oxaliplatin (FOLFOX) or 5‐fluorouracil/leucovorin/irinotecan (FOLFIRI). STEAM (NCT01765582) assessed the efficacy of BEV plus FOLFOX/FOLFIRI (FOLFOXIRI), administered concurrently (cFOLFOXIRI‐BEV) or sequentially (sFOLFOXIRI‐BEV, FOLFOX‐BEV alternating with FOLFIRI‐BEV), versus FOLFOX‐BEV for mCRC.Patients and Methods.Patients with previously untreated mCRC (n = 280) were randomized 1:1:1 to cFOLFOXIRI‐BEV, sFOLFOXIRI‐BEV, or FOLFOX‐BEV a...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Herbert I. Hurwitz, Benȷamin R. Tan, James A. Reeves, Henry Xiong, Brad Somer, Heinz-Josef Lenz, Howard S. Hochster, Frank Scappaticci, John F. Palma, Richard Price, John J. Lee, Alan Nicholas, Nicolas Sommer, Johanna Bendell Tags: Gastrointestinal Cancer Source Type: research

High‐Grade Gastrointestinal Neuroendocrine Carcinoma Management and Outcomes: A National Cancer Database Study
AbstractBackground.High‐grade neuroendocrine carcinomas are rare in the gastrointestinal tract. However, treatment patterns and outcomes have not been well described.Subjects, Materials, and Methods.The National Cancer Database was analyzed. The primary objective was to describe the clinical outcomes and identify prognostic factors. Univariate and multivariate analyses were done to identify factors associated with patient outcome.Results.A total of 1,861 patients were identified between 2004 and 2013. The mean age was 63 years (standard deviation ±13). The majority of the patients (78.1%) were non‐Hispanic white...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Olatunȷi B. Alese, Renȷian Jiang, Walid Shaib, Christina Wu, Mehmet Akce, Madhusmita Behera, Bassel F. El-Rayes Tags: Gastrointestinal Cancer Source Type: research

Bridge: Person‐Centered Collaborative Care for Patients with Serious Mental Illness and Cancer
Conclusion.Bridge is a feasible and acceptable care delivery model for patients with SMI, their caregivers, and oncology clinicians. Randomized trials are warranted to assess the efficacy of improving cancer outcomes in this underserved population.Implications for Practice.Serious mental illness affects 13 million U.S. adults who experience increased cancer mortality. To improve outcomes, new models of integrated oncology and mental health care are urgently needed. This study found that it was feasible to identify, enroll, and retain patients with serious mental illness and a new cancer in a trial of integrated mental heal...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Kelly E. Irwin, Elyse R. Park, Lauren E. Fields, Amy E. Corveleyn, Joseph A. Greer, Giselle K. Perez, Catherine A. Callaway, Jamie M. Jacobs, Andrew A. Nierenberg, Jennifer S. Temel, David P. Ryan, William F. Pirl Tags: Symptom Management and Supportive Care, Community Outreach Source Type: research

Everolimus plus Exemestane for Hormone Receptor‐Positive Advanced Breast Cancer: A PAM50 Intrinsic Subtype Analysis of BOLERO‐2
Conclusion.The HER2‐enriched subtype was identified in a substantial proportion of advanced HR+/HER2‐negative breast tumors, and was a consistent biomarker of poor prognosis. Tailored therapies are therefore needed for HER2‐enriched tumors in the advanced HR+/HER2‐negative breast cancer setting.Implications for Practice.Using 261 tumor samples from the BOLERO‐2 phase III clinical trial, this study shows that a substantial proportion (20%–30%) of hormone receptor‐positive (HR+)/human epidermal growth factor receptor 2 (HER2)‐negative advanced breast cancers do not have a luminal A or B gene expression pr...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Aleix Prat, Jan Christoph Brase, Yuan Cheng, Paolo Nuciforo, Laia Pare, Tomas Pascual, Debora Martinez, Patricia Galvan, Maria Vidal, Barbara Adamo, Gabriel N. Hortobagyi, Jose Baselga, Eva Ciruelos Tags: Breast Cancer Source Type: research

A Phase I/II Open‐Label Study of Nivolumab in Previously Treated Advanced or Recurrent Nasopharyngeal Carcinoma and Other Solid Tumors
Conclusion.Nivolumab monotherapy at 3 mg/kg and flat doses of 240 mg and 360 mg were well tolerated in this Chinese patient population, with PK profiles at 3 mg/kg being similar to those of global patients. Preliminary efficacy results showed promising antitumor activity of nivolumab in advanced NPC. (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Yuxiang Ma, Wenfeng Fang, Yang Zhang, Yunpeng Yang, Shaodong Hong, Yuanyuan Zhao, Amol Tendolkar, Lu Chen, Dong Xu, Jennifer Sheng, Hongyun Zhao, Li Zhang Tags: Chinese Edition, Clinical Trial Results Source Type: research

Adjuvant Zoledronic Acid in High‐Risk Giant Cell Tumor of Bone: A Multicenter Randomized Phase II Trial
Conclusion.Adjuvant treatment with zoledronic acid did not decrease the recurrence rate of GCTB in this study. The efficacy could not be determined because of the small sample size. Because recurrences, even in the denosumab era, are still an issue, a randomized study exploring the efficacy of zoledronic acid in the adjuvant setting in GCTB is still valid. (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Astrid Lipplaa, Judith R. Kroep, Lizz van der Heijden, Paul C. Jutte, Pancras C.W. Hogendoorn, Sander Dijkstra, Hans Gelderblom Tags: Chinese Edition, Clinical Trial Results Source Type: research

A Phase II Trial of Selinexor (KPT‐330) for Metastatic Triple‐Negative Breast Cancer
Conclusion.Selinexor was fairly well tolerated in patients with advanced TNBC but did not result in objective responses. However, clinical benefit rate was 30%, and further investigation of selinexor in this patient population should focus on combination therapies. (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Michael Shafique, Roohi Ismail-Khan, Martine Extermann, Dan Sullivan, Dawn Goodridge, David Boulware, Deanna Hogue, Hatem Soliman, Hung Khong, Hyo S. Han Tags: Breast Cancer, Chinese Edition, Clinical Trial Results Source Type: research

Adapalene Gel 0.1% Versus Placebo as Prophylaxis for Anti‐Epidermal Growth Factor Receptor‐Induced Acne‐Like Rash: A Randomized Left‐Right Comparative Evaluation (APPEARANCE)
Conclusion.Adapalene is not recommended as prophylaxis against acne‐like rash induced by anti‐EGFR therapies. (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Naoko Chayahara, Toru Mukohara, Motoko Tachihara, Yoshimi Fujishima, Atsushi Fukunaga, Ken Washio, Masatsugu Yamamoto, Kyosuke Nakata, Kazuyuki Kobayashi, Kei Takenaka, Masanori Toyoda, Naomi Kiyota, Kazutoshi Tobimatsu, Hisayo Doi, Naomi Mizuta, Naho Mar Tags: Head and Neck Cancers, Lung Cancer, Chinese Edition, Clinical Trial Results, Gastrointestinal Cancer Source Type: research

A Single‐Arm, Phase II Study of Apatinib in Refractory Metastatic Colorectal Cancer
Conclusion.Apatinib monotherapy showed promising efficiency for patients with refractory colorectal cancer, especially in patients with PS 0–1 or no liver metastasis. ctDNA abundance may be a predictor in serial monitoring of tumor load. (Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Xiaofeng Chen, Tianzhu Qiu, Yingwei Zhu, Jing Sun, Ping Li, Biao Wang, Peinan Lin, Xiaomin Cai, Xiao Han, Fengjiao Zhao, Yongqian Shu, Lianpeng Chang, Hua Jiang, Yanhong Gu Tags: Chinese Edition, Clinical Trial Results, Gastrointestinal Cancer Source Type: research

Suspected Hereditary Cancer Syndromes in Young Patients: Heterogeneous Clinical and Genetic Presentation of Colorectal Cancers
This article describes the cases of two young male patients, who presented with locally advanced and metastatic CRC, and reports the results of the germline mutational analyses done for both patients. These cases demonstrate the importance of special care and molecular diagnostic procedures for young patients with CRC.Key Points. Patients with colorectal cancer who are younger than 50 years at initial diagnosis (early onset) should routinely undergo genetic testing.Early‐ and very‐early‐onset patients (younger than 40 years) with absence of microsatellite instability should be considered for tumor mutation burden tes...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Claudia Maletzki, Maȷa Huhns, Ingrid Bauer, Friedrich Prall, Christian Junghanss, Larissa Henze Tags: Precision Medicine Clinic: Molecular Tumor Board, Gastrointestinal Cancer Source Type: research

Severe Epididymo‐Orchitis and Encephalitis Complicating Anti‐PD‐1 Therapy
We describe herein a patient with metastatic melanoma who developed epididymo‐orchitis followed by encephalitis while receiving pembrolizumab. The patient developed testicular pain and fever after his third dose of pembrolizumab; ultrasound evaluation demonstrated bilateral epididymo‐orchitis. He then developed headaches, fever, and altered mental status over the next week and was admitted to the hospital. Lumbar puncture revealed inflammatory changes consistent with meningoencephalitis; he did not improve with broad‐spectrum antibiotics, and an extensive workup for infectious etiologies, including cerebrospinal flui...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Henry T. Quach, Charles J. Robbins, Justin M. Balko, Charles Y. Chiu, Steve Miller, Michael R. Wilson, George E. Nelson, Douglas B. Johnson Tags: Melanoma and Cutaneous Malignancies Immune ‐ Related Adverse Events Source Type: research

How Do the Accrual Pattern and Follow‐Up Duration Affect the Hazard Ratio Estimate When the Proportional Hazards Assumption Is Violated?
(Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Miki Horiguchi, Michael J. Hassett, Hajime Uno Tags: Clinical Trial Results Commentaries Source Type: research

Care for Smoking Cessation Must Be Proactive and Based on a Combination of Pharmacology and Psychology
(Source: The Oncologist)
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Alain Braillon Tags: Health Outcomes and Economics of Cancer Care Letter to the Editor Source Type: research

Feasibility of Bronchial Washing Fluid‐Based Approach to Early‐Stage Lung Cancer Diagnosis
AbstractA blood‐based approach such as circulating tumor DNA remains challenging in diagnosis for early‐stage disease. Bronchial washing (BW) is a minimally invasive procedure that yields fluids that may contain tumor DNA. Therefore, we prospectively enrolled 12 patients with early‐stage non‐small cell lung cancer without endoscopically visible tumors. Somatic mutations were analyzed using ultra‐deep next‐generation sequencing in 48 paired specimens (primary tumor tissue, normal tissue, BW supernatant, and BW precipitate). In primary tumors, 130 missense mutations/indels (5–16 per patient) and 20 driver m...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Jeong-Seon Ryu, Jun Hyeok Lim, Myoung Kyu Lee, Seung Jae Lee, Hyun-Jung Kim, Min Jeong Kim, Mi Hwa Park, Jung Soo Kim, Hae-Seong Nam, Nuri Park, Seok Joong Yong Tags: Lung Cancer Brief Communications Source Type: research

Cardiotoxicity Monitoring in Patients Treated with Tyrosine Kinase Inhibitors
We describe two cases of TKI‐induced heart failure (HF) that suggest the utility of monitoring with laboratory tests is questionable. One patient developed HF 5 days after starting pazopanib. The other developed HF while receiving 25 mg per day sunitinib, and had previously received a higher dose (50 mg per day) with no symptoms of cardiotoxicy. In addition, she later received 5 cycles of sunitinib (25 mg per day) without developing an abnormal left ventricular ejection fraction (LVEF) value by echocardiography or cardiac symptoms. Although the LVEF is commonly performed to monitor TKI cardiotoxicity, evidence for its pr...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Keith M. Skubitz Tags: New Drug Development and Clinical Pharmacology, Sarcomas Brief Communications Source Type: research

Inhibition of Serotonin Synthesis May Have Antitumor Activity? Long‐Term Efficacy in a Patient with Gastrointestinal Neuroendocrine Tumor
AbstractIn this article, we propose, based on a clinical case, the potential antitumor effect related to the inhibition of serotonin in neuroendocrine tumors (NETs). Currently, the only drug that exists for the symptomatic treatment of carcinoid syndrome refractory to somatostatin analogues is telotristat, based on its pivotal study, the TELESTAR trial. Based on the existing preclinical rationale, it seems that the inhibition of serotonin may have an antitumoral role in NETs. Briefly, serotonin may act as an autocrine growth factor of NETs, and it may also play an immunomodulatory role by enhancing macrophage polarization ...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Javier Molina-Cerrillo, Enrique Grande, Teresa Alonso-Gordoa Tags: New Drug Development and Clinical Pharmacology, Endocrinology Brief Communications Source Type: research

Minimally Invasive Cordotomy for Refractory Cancer Pain: A Randomized Controlled Trial
Conclusion.These data support the use of cordotomy for pain refractory to optimal palliative care. The findings of this study justify a large‐scale randomized controlled trial of percutaneous cordotomy.Implications for Practice.This prospective clinical trial was designed to determine the improvement in pain intensity in patients randomized to either undergo cordotomy or comprehensive palliative care for medically refractory cancer pain. This study shows that cordotomy is effective in reducing pain for medically refractory cancer pain, and these results can be used to design a large‐scale comparative randomized control...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Ashwin Viswanathan, Aditya Vedantam, Kenneth R. Hess, Jewel Ochoa, Patrick M. Dougherty, Akhila S. Reddy, Dhanalakshmi Koyyalagunta, Suresh Reddy, Eduardo Bruera Tags: Symptom Management and Supportive Care Source Type: research

Effects of Oral Morphine on Dyspnea in Patients with Cancer: Response Rate, Predictive Factors, and Clinically Meaningful Change (CJLSG1101)
Conclusion.Oral morphine was effective and feasible for treating cancer‐related dyspnea. A higher score for “sense of discomfort” on the CDS and a smaller cumulative amount of smoking may be predictive factors of the effectiveness of oral morphine.Implications for Practice.This study demonstrated that oral morphine was effective in alleviating cancer‐related dyspnea due to multiple factors including primary lung lesions, airway narrowing, and pleural effusion. Approximately 76% of patients reported that oral morphine was effective. A higher score for “sense of discomfort” on the Cancer Dyspnea S...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Kosuke Takahashi, Masashi Kondo, Masahiko Ando, Akira Shiraki, Harunori Nakashima, Hisashi Wakayama, Kensuke Kataoka, Masashi Yamamoto, Yasuteru Sugino, Mitsunori Nishikawa, Kazuyoshi Imaizumi, Eiji Kojima, Atsushi Sumida, Yoshihiro Takeyama, Hiroshi Sait Tags: Symptom Management and Supportive Care Source Type: research

Current Pharmacotherapy Does Not Improve Severity of Hypoactive Delirium in Patients with Advanced Cancer: Pharmacological Audit Study of Safety and Efficacy in Real World (Phase‐R)
Conclusion.Current pharmacotherapy for hypoactive delirium in patients with advanced cancer is not recommended, especially in those whose death is expected within a few days and in those with delirium caused by organ failure.Implications for Practice.Delirium is common among patients with advanced cancer, and hypoactive delirium is the dominant motor subtype in the palliative care setting. Pharmacotherapy is recommended and regularly used to treat delirium. This article describes the effectiveness and adverse effects of pharmacotherapy for hypoactive delirium in patients with advanced cancer. The findings of this study do ...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Toru Okuyama, Kazuhiro Yoshiuchi, Asao Ogawa, Satoru Iwase, Naosuke Yokomichi, Akihiro Sakashita, Keita Tagami, Keiichi Uemura, Rika Nakahara, Tatsuo Akechi, on behalf of Phase-R Delirium Study Group Tags: Symptom Management and Supportive Care Source Type: research

Patient‐Reported Outcomes with PD‐1/PD‐L1 Inhibitors for Advanced Cancer: A Meta‐Analysis
AbstractBackground.The aim of this meta‐analysis was to compare patient‐reported outcomes (PROs) between programmed death receptor‐1/programmed death‐ligand 1 (PD‐1/PD‐L1) inhibitors and standard‐of‐care therapy in patients with advanced cancer.Methods.We searched randomized controlled trials (RCTs) comparing single‐agent PD‐1/PD‐L1 inhibitors (nivolumab, pembrolizumab, atezolizumab, avelumab, or durvalumab) with standard‐of‐care therapy in patients with advanced cancer reporting PROs with generic measures: the European Organisation for Research and Treatment of Cancer Quality of Life Questionnair...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Tomohiro F. Nishijima, Shlomit S. Shachar, Hyman B. Muss, Kazuo Tamura Tags: Symptom Management and Supportive Care Source Type: research

Outcome of Patients with Soft‐Tissue Sarcomas: An Age‐Specific Conditional Survival Analysis
Conclusion.Conditional survival estimates show clinically relevant variations according to time since first diagnosis in both young and elderly patients with STS. These results can help STS survivors adjust their view of the future and STS care providers plan patient follow‐up.Implications for Practice.For patients with sarcoma who are followed up years after being treated for their disease, a common scenario is for the patient and caregivers to ask practitioners what the longer‐term prognosis may be. The question posed to practitioners may be, “Doc, am I now cured? It's been 5 years since we finished treatment.&...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Kevin Bourcier, Derek Dinart, Axel Le Cesne, Charles Honore, Pierre Meeus, Jean-Yves Blay, Audrey Michot, Francois Le Loarer, Antoine Italiano Tags: Sarcomas Source Type: research

Clinical and Prognostic Characteristics of 53 Cases of Extracranial Malignant Rhabdoid Tumor in Children. A Single‐Institute Experience from 2007 to 2017
Conclusion.Extracranial MRT is still a highly aggressive tumor in children. Younger patients and those suffering from metastatic disease were most likely to have a poor outcome because of rapid progression or recurrence of the tumor.Implications for Practice.This is the largest single‐institutional report that investigates the clinical characteristics and outcomes of extracranial malignant rhabdoid tumor (MRT) in China. Our study showed that gross hematuria and tumor rupture were typical characteristics of malignant rhabdoid tumor of the kidney. After survival analysis, it was found that the advanced stage of the tumor a...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Haiyan Cheng, Shen Yang, Siyu Cai, Xiaoli Ma, Hong Qin, Weiping Zhang, Libing Fu, Qi Zeng, Mingjie Wen, Xiaoxia Peng, Huanmin Wang Tags: Sarcomas Source Type: research

Apatinib for Advanced Osteosarcoma after Failure of Standard Multimodal Therapy: An Open Label Phase II Clinical Trial
Conclusion.Apatinib is a sensitive drug for advanced osteosarcoma with a high response rate after failure of chemotherapy, with similar duration of response compared to other TKIs.Implications for Practice.For advanced osteosarcoma progressing upon chemotherapy, antiangiogenesis tyrosine kinase inhibitors (TKIs) have been proved to be effective in prolonging the progression‐free survival in previous multicenter trials and have been included into new National Comprehensive Cancer Network guidelines as second‐line therapy. Apatinib is a TKI that specifically inhibits vascular endothelial growth factor receptor‐2, which...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Lu Xie, Jie Xu, Xin Sun, Xiaodong Tang, Taiqiang Yan, Rongli Yang, Wei Guo Tags: New Drug Development and Clinical Pharmacology, Sarcomas Source Type: research

Treatment Outcomes and Sensitivity to Hormone Therapy of Aggressive Angiomyxoma: A Multicenter, International, Retrospective Study
Conclusion.Our findings confirm that in AA, surgical local control may be challenging, with a significant rate of local relapse despite complete surgery. Hormone therapy is an active treatment option, with a potential of disease control and of being combined with surgery. The addition of an AI to first‐line GnRHa could be an effective second‐line systemic therapy in premenopausal female patients with AA.Implications for Practice.In this retrospective effort including 36 patients with aggressive angiomyxoma, local relapse rate after complete surgery was 50%, with a median relapse‐free survival of 39 months, confirming...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Giovanni Fuca, Nadia Hindi, Isabelle Ray-Coquard, Vittoria Colia, Angelo Paolo Dei Tos, Javier Martin-Broto, Mehdi Brahmi, Paola Collini, Domenica Lorusso, Francesco Raspagliesi, Maria Abbondanza Pantaleo, Bruno Vincenzi, Elena Fumagalli, Alessandro Gronc Tags: Sarcomas Source Type: research

Minimal Increase in Survival Throughout the Years in Patients with Soft Tissue Sarcoma with Synchronous Metastases: Results of a Population‐Based Study
Conclusion.Although overall survival of patients with STS with synchronous metastases in this nationwide and “real‐life” population has improved over the years, the improvement was not statistically significant, despite new treatment options.Implications for Practice.Treatment of patients with metastatic soft tissue sarcoma (STS) has changed in the past years, with new drugs such as trabectedin (2007) and pazopanib (2012) becoming available. By using data from the nationwide Netherlands Cancer Registry, the impact of these changes in treatment policies on survival is analyzed in a “real‐life” po...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Melissa Vos, Vincent K. Y. Ho, Astrid W. Oosten, Cornelis Verhoef, Stefan Sleijfer Tags: Sarcomas, European Perspectives Source Type: research

Referrals to a Phase I Clinic and Trial Enrollment in the Molecular Screening Era
Conclusion.Although nearly half of new patients referred to a phase I clinic had prior molecular profiling, the proportion subsequently enrolled into clinical trials was low. Prior molecular profiling was not an independent predictor of clinical trial enrollment.Implications for Practice.The landscape of oncology drug development is evolving alongside technological advancements. Recently, large academic medical centers have implemented clinical sequencing protocols to identify patients with actionable genomic alterations to enroll in therapeutic clinical trials. This study evaluates patient referral and enrollment patterns...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Tira Tan, Michael Rheaume, Lisa Wang, Helen Chow, Anna Spreafico, Aaron R. Hansen, Albiruni R.A. Razak, Lillian L. Siu, Philippe L. Bedard Tags: New Drug Development and Clinical Pharmacology, Precision Medicine Clinic: Molecular Tumor Board, Health Outcomes and Economics of Cancer Care, Cancer Diagnostics and Molecular Pathology Source Type: research

Systemic Therapy Use and Outcomes After Relapse from Preoperative Radiation and Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma
AbstractBackground.Multimodality therapy with preoperative radiation (RT) followed by extrapleural pneumonectomy (EP) for patients with operable malignant pleural mesothelioma (MPM) has demonstrated encouraging results. At relapse, there are few data on the tolerance and efficacy of systemic therapies after prior multimodality therapy.Materials and Methods.We conducted a retrospective analysis of patients with relapsed MPM after RT and EPP ± adjuvant chemotherapy to determine overall survival (OS; date of relapse to death) and the proportion of patients that received systemic therapy and associated response rate (RR...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Sara V. Soldera, John Kavanagh, Melania Pintilie, Natasha B. Leighl, Marc de Perrot, John Cho, Andrew Hope, Ronald Feld, Penelope A. Bradbury Tags: Lung Cancer Source Type: research

The Impact of Brain Metastases and Associated Neurocognitive Aspects on Health Utility Scores in EGFR Mutated and ALK Rearranged NSCLC: A Real World Evidence Analysis
AbstractBackground.In lung cancer, brain metastases (BM) and their treatment are associated with high economic burden and inferior health‐related quality of life. In the era of targeted therapy, real world evidence through health utility scores (HUS) is critical for economic analyses.Materials and Methods.In a prospective observational cohort study (2014–2016), outpatients with stage IV lung cancer completed demographic and EQ‐5D‐3L surveys (to derive HUS). Health states and clinicopathologic variables were obtained from chart abstraction. Patients were categorized by the presence or absence of BM; regression a...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Grainne M. O'Kane, Jie Su, Brandon C. Tse, Vivian Tam, Tiffany Tse, Lin Lu, Michael Borean, Emily Tam, Catherine Labbe, Hiten Naik, Nicole Mittmann, Mark K. Doherty, Penelope A. Bradbury, Natasha B. Leighl, Frances A. Shepherd, Nadine M. Richard, Kim Edel Tags: Lung Cancer, Symptom Management and Supportive Care, Health Outcomes and Economics of Cancer Care Source Type: research

Long‐Term Gynecological Cancer Survivors in Côte d'Or: Health‐Related Quality of Life and Living Conditions
Conclusions.Long‐term HRQoL of survivors of gynecological cancer is not impacted by stage of disease. Specific interventions should focus on issues that promote social and professional reintegration and improve HRQoL.Implications for Practice.This study shows that women with gynecological cancer have problems related to work and sexual dysfunction, even 5 years after diagnosis. The results of this study will help improve clinicians’ awareness of the factors affecting the lives of gynecological cancer survivors, even long after diagnosis and treatment. They will also highlight for clinicians the areas that are of im...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Ariane Mamguem Kamga, Agnes Dumas, Florence Joly, Oumar Billa, Julien Simon, Marie-Laure Poillot, Ariane Darut-Jouve, Charles Coutant, Pierre Fumoleau, Patrick Arveux, Tienhan Sandrine Dabakuyo-Yonli Tags: Gynecologic Oncology, Global Health and Cancer Source Type: research

Prevalence of Burnout and Career Satisfaction Among Oncologists in China: A National Survey
AbstractBackground.Burnout and career satisfaction has been extensively studied among U.S. and European oncologists, although little is known about the situation among Chinese oncologists. Therefore, we conducted this national survey to investigate the prevalence of burnout and career satisfaction among Chinese oncologists.Patients and Methods.Between September 2015 and December 2016, a cross‐sectional field survey was conducted through the Chinese Society of Clinical Oncology and the Chinese Committee of Rehabilitation and Palliative Care. The full‐length survey consisted of 59 questions investigating personal and pro...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Shuxiang Ma, Yan Huang, Yunpeng Yang, Yuxiang Ma, Ting Zhou, Hongyun Zhao, Likun Chen, Ningning Zhou, Li Zhang Tags: Health Outcomes and Economics of Cancer Care, Global Health and Cancer Source Type: research

Low Prevalence of the Four Common Colombian Founder Mutations in BRCA1 and BRCA2 in Early‐Onset and Familial Afro‐Colombian Patients with Breast Cancer
Conclusion.Our data showed a low prevalence of the BRCA1/2 founder mutations in Colombians of African descent, implying that these mutations should not be recommended for genetic screening programs in the Afro‐Colombian population.Implications for Practice.Risk reduction intervention programs are needed for women who are found to carry a BRCA1/2 mutation, as is the implementation of prevention programs for patients with inherited breast cancer, to reduce the burden of inherited diseases. With the aim of reducing racial disparities in breast cancer prevention, this study focused on genetic testing and treatment for patien...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Elizabeth Vargas, Diana Maria Torres Lopez, Robert de Deugd, Fabian Gil, Aleȷandra Nova, Lina Mora, Luis Fernando Viana, Jose David Hernandez, Ricardo Bruges, Ute Hamann Tags: Breast Cancer, Global Health and Cancer Source Type: research

Impact of Comorbidities and Age on Cause‐Specific Mortality in Postmenopausal Patients with Breast Cancer
AbstractBackground.The aim was to study the impact of comorbidities and age on breast cancer mortality, taking into account competing causes of death.Subjects, Materials, and Methods.Cohort analysis of Dutch and Belgian patients with postmenopausal, early hormone receptor‐positive breast cancer included in the Tamoxifen and Exemestane Adjuvant Multinational (TEAM) trial between 2001 and 2006. This is a randomized controlled trial of patients who had completed local treatment with curative intent and were randomized to receive exemestane for 5 years, or sequential treatment of tamoxifen followed by exemestane for a durati...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Marloes G.M. Derks, Cornelis J.H. van de Velde, Daniele Giardiello, Caroline Seynaeve, Hein Putter, Johan W.R. Nortier, Luc Y. Dirix, Esther Bastiaannet, Johanneke E.A. Portielȷe, Gerrit-Jan Liefers Tags: Geriatric Oncology Source Type: research

Depressive Symptom Profiles and Survival in Older Patients with Cancer: Latent Class Analysis of the ELCAPA Cohort Study
Conclusion.A data‐driven approach based on depressive symptoms identified five different depressive symptom profiles, including demoralization, in older patients with cancer. Severe depression was independently and substantially associated with poor survival.Implications for Practice.Older patients with cancer present with distinct profiles of depressive symptomatology, including different severity levels of depression and the demoralization syndrome. Clinicians should use a systematic assessment of depressive symptoms to adequately highlight these distinct profiles. Geriatric and oncological features are differently ass...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Clement Gouraud, Elena Paillaud, Claudia Martinez-Tapia, Lauriane Segaux, Nicoleta Reinald, Marie Laurent, Lola Corsin, Nicolas Hoertel, Mathilde Gisselbrecht, Elise Mercadier, Pascaline Boudou-Rouquette, Anne Chahwakilian, Sylvie Bastuȷi-Garin, Fr Tags: Geriatric Oncology Source Type: research

Large‐Scale, Prospective Observational Study of Regorafenib in Japanese Patients with Metastatic Colorectal Cancer in a Real‐World Clinical Setting
Conclusion.The outcomes of this study were consistent with those of clinical trials. There were no new safety concerns. Regorafenib treatment would not be recommended for patients with higher PS.Implications for Practice.Previous clinical trials demonstrated regorafenib improved overall survival in patients with metastatic colorectal cancer who progress after standard chemotherapies. Because the eligibility criteria of the trials were restricted compared with a real‐world setting, the data from the trials may not fully represent the profiles of regorafenib in clinical practice. This large‐scale observational study show...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Kensei Yamaguchi, Yoshito Komatsu, Taroh Satoh, Hiroyuki Uetake, Takayuki Yoshino, Toshirou Nishida, Naoya Yamazaki, Hajime Takikawa, Takashi Morimoto, Masayuki Chosa, Toshiyuki Sunaya, Yoko Hamada, Kei Muro, Kenichi Sugihara Tags: Gastrointestinal Cancer Source Type: research

Mixed Invasive Ductal and Lobular Carcinoma of the Breast: Prognosis and the Importance of Histologic Grade
Conclusion.IDC‐L tumors have a better prognosis than ILC tumors, particularly among postmenopausal women. Histologic grade is an important prognostic factor in IDC‐L but not in ILC.Implications for Practice.This study compared mixed invasive ductal and lobular carcinoma (IDC‐L) with invasive lobular carcinomas (ILCs) to assess the overall prognosis, the prognostic role of histologic grade, and response to systemic therapy. It was found that patients with IDC‐L tumors have a better prognosis than ILC, particularly among postmenopausal women, which may impact follow‐up strategies. Moreover, although histologic grad...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Otto Metzger-Filho, Arlindo R. Ferreira, Rinath Jeselsohn, William T. Barry, Deborah A. Dillon, Jane E. Brock, Ines Vaz-Luis, Melissa E. Hughes, Eric P. Winer, Nancy U. Lin Tags: Breast Cancer Source Type: research

Twenty Years with Personalized Medicine: Past, Present, and Future of Individualized Pharmacotherapy
AbstractOn April 16, 1999, a short article appeared in The Wall Street Journal entitled “New Era of Personalized Medicine: Targeting Drugs for Each Unique Genetic Profile,” and here, the public was introduced to the term “personalized medicine” for the first time. A few months after publication of the article, it was reprinted in The Oncologist. The article describes the formation of the Single Nucleotide Polymorphisms Consortium, which was established as a collaboration between a number of major pharmaceutical companies and several academic research institutions, with support from the Wellcome Trus...
Source: The Oncologist - July 17, 2019 Category: Cancer & Oncology Authors: Jan Trost Jorgensen Tags: New Drug Development and Clinical Pharmacology, Cancer Diagnostics and Molecular Pathology Commentaries Source Type: research

Incorporating MicroRNA into Molecular Phenotypes of Circulating Tumor Cells Enhances the Prognostic Accuracy for Patients with Metastatic Breast Cancer.
CONCLUSION: The phenotypic assemblies of CTC incorporating miR-106b show enhanced prognostic accuracy of overall survival in patients with MBC. IMPLICATIONS FOR PRACTICE: In order to enhance the prognostic accuracy of the circulating tumor cell (CTC) phenotype in patients with metastatic breast cancer (MBC), this study screened and identified a CTC-specific microRNA (miRNA), miR-106b, as an upregulated molecule based on the comparison of miRNA profile between CTCs, primary tumors, and healthy blood donors. By incorporating miR-106b into a combined prediction model, the prognostic accuracy of the CTC phenotype for pati...
Source: The Oncologist - July 12, 2019 Category: Cancer & Oncology Authors: Tan W, Liang G, Xie X, Jiang W, Tan L, Sanders AJ, Liu Z, Ling Y, Zhong W, Tian Z, Lin W, Gong C Tags: Oncologist Source Type: research

Long-Term Experience of Chemoradiotherapy Combined with Deep Regional Hyperthermia for Organ Preservation in High-Risk Bladder Cancer (Ta, Tis, T1, T2).
CONCLUSION: The multimodal treatment consisted of a maximal TUR-BT followed by RT; concomitant platinum-based chemotherapy combined with RHT in patients with high-grade bladder cancer improves local control, bladder-preservation rate, and OS. It offers a promising alternative to surgical therapies like radical cystectomy. IMPLICATIONS FOR PRACTICE: Radical cystectomy with appropriate lymph node dissection has long represented the standard of care for muscle-invasive bladder cancer in medically fit patients, despite many centers reporting excellent long-term results for bladder preserving strategies. This retrospective...
Source: The Oncologist - July 10, 2019 Category: Cancer & Oncology Authors: Merten R, Ott O, Haderlein M, Bertz S, Hartmann A, Wullich B, Keck B, Kühn R, Rödel CM, Weiss C, Gall C, Uter W, Fietkau R Tags: Oncologist Source Type: research