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Phase II Study to Evaluate the Efficacy and Safety of Rilotumumab and Bevacizumab in Subjects with Recurrent Malignant Glioma.
CONCLUSION: Rilotumumab with BEV did not significantly improve objective response compared with BEV alone, and toxicity may preclude the use of rilotumumab in combination BEV regimens. PMID: 29666296 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - April 17, 2018 Category: Cancer & Oncology Authors: Affronti ML, Jackman JG, McSherry F, Herndon JE, Massey EC, Lipp E, Desjardins A, Friedman HS, Vlahovic G, Vredenburgh J, Peters KB Tags: Oncologist Source Type: research

Phase II Study of Everolimus in Metastatic Malignant Melanoma (NCCTG-N0377, Alliance).
CONCLUSION: Everolimus does not have sufficient single-agent activity in MM; however, we have identified evidence of biological activity to provide a potential rationale for future combination studies. PMID: 29666297 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - April 17, 2018 Category: Cancer & Oncology Authors: Vera Aguilera J, Rao RD, Allred JB, Suman VJ, Windschitl HE, Kaur JS, Maples WJ, Lowe VJ, Creagan ET, Erickson LA, Markovic S Tags: Oncologist Source Type: research

Delayed Autoimmune Toxicity Occurring Several Months After Cessation of Anti-PD-1 Therapy.
This study describes for the first time a case of delayed autoimmunity occurring 8 months after discontinuing treatment with the anti-PD-1 antibody nivolumab in a patient with metastatic melanoma. The case highlights the need for ongoing surveillance of patients treated with immune checkpoint inhibitors even after cessation of therapy, especially as patients increasingly stop treatment after achieving durable responses. PMID: 29666298 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - April 17, 2018 Category: Cancer & Oncology Authors: Parakh S, Cebon J, Klein O Tags: Oncologist Source Type: research

Canakinumab and Lung Cancer: Intriguing, but Is It Real?
PMID: 29666299 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - April 17, 2018 Category: Cancer & Oncology Authors: Chabner BA, Nabel CS Tags: Oncologist Source Type: research

FDA Approval Summary: Mylotarg for Treatment of Patients with Relapsed or Refractory CD33-Positive Acute Myeloid Leukemia.
Abstract On 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...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Norsworthy KJ, Ko CW, Lee JE, Liu J, John CS, Przepiorka D, Farrell AT, Pazdur R Tags: Oncologist Source Type: research

Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors for Central Nervous System Metastases from Non-Small Cell Lung Cancer.
Abstract Central 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 propertie...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Ahluwalia MS, Becker K, Levy BP Tags: Oncologist Source Type: research

Osimertinib: A Novel Dermatologic Adverse Event Profile in Patients with Lung Cancer.
Abstract Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. First- and second-generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third-generation EGFR-TKIs. Herein, we describe the dAEs associated with third-generation EGFR-TKIs and our clinical experience with osimertinib, a third-generation EGFR-TKI a...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Chu CY, Choi J, Eaby-Sandy B, Langer CJ, Lacouture ME Tags: Oncologist Source Type: research

Use of Direct Oral Anticoagulants in Patients with Cancer: Practical Considerations for the Management of Patients with Nausea or Vomiting.
We present these consensus recommendations, which outline strategies for the use and management of anticoagulants, including DOACs, in patients with VTE or AF and cancer for whom oral drug intake may pose challenges. Guidance is provided on managing patients with gastrointestinal obstruction or nausea and vomiting that is caused by cancer treatments or other cancer-related factors.The recommendations outlined in this review provide a useful reference for health care professionals and will help to improve the management of anticoagulation in patients with VTE or AF and cancer. IMPLICATIONS FOR PRACTICE: Direct oral ant...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Riess H, Ay C, Bauersachs R, Becattini C, Beyer-Westendorf J, Cajfinger F, Chau I, Cohen AT, Khorana AA, Maraveyas A, Renni M, Young AM Tags: Oncologist Source Type: research

The Eighth Edition of TNM Staging of Lung Cancer: Reference Chart and Diagrams.
Abstract Lung cancer is the leading cause of cancer-related mortality in the U.S. TNM staging of lung cancer is implemented to define the extent of disease and consequently assign prognosis and guide treatment. The newest edition of TNM staging of lung cancer has been released recently. In this article, we present the TNM staging of lung cancer in a concise, yet comprehensive, visual format. PMID: 29650687 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Lababede O, Meziane MA Tags: Oncologist 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.
f WTA Abstract BACKGROUND: 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). RESULT...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Younger E, Litière S, Le Cesne A, Mir O, Gelderblom H, Italiano A, Marreaud S, Jones RL, Gronchi A, van der Graaf WTA Tags: Oncologist Source Type: research

Two Doctors, One Patient, and a Common Goal
(Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Chadi Nabhan, Jeremy Topin Tags: Narratives in Oncology Source Type: research

Perception of Curability Among Advanced Cancer Patients: An International Collaborative Study
AbstractBackground.There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe.Materials and Methods.Secondary analysis of a study to understand the core concepts in end‐of‐life care among advanced cancer patients receiving palliative care from 11 countries across the world. Advanced cancer patients were surveyed using a Patient Illness Understanding survey and Control Pref...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Sriram Yennuraȷalingam, Luis Fernando Rodrigues, Omar Shamieh, Colombe Tricou, Marilene Filbet, Kyaw Naing, Akhileshwaran Ramaswamy, Pedro Emilio Perez-Cruz, Mary Jocelyn S. Bautista, Sofia Bunge, Mary Ann Muckaden, Vikash Sewram, Sarah Fakrooden, Tags: Symptom Management and Supportive Care Source Type: research

Benefit‐Risk Summary of Regorafenib for the Treatment of Patients with Advanced Hepatocellular Carcinoma That Has Progressed on Sorafenib
AbstractOn April 27, 2017, the U.S. Food and Drug Administration approved regorafenib for the treatment of patients with advanced hepatocellular carcinoma (HCC) who had previously been treated with sorafenib. Approval was based on the results of a single, randomized, placebo‐controlled trial (RESORCE) that demonstrated an improvement in overall survival (OS). Patients were randomly allocated to receive regorafenib160 mg orally once daily or matching placebo for the first 21 days of each 28‐day cycle. The trial demonstrated a significant improvement in OS (hazard ratio [HR] = 0.63; 95% confidence interval ...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Lorraine Pelosof, Steven Lemery, Sandra Casak, Xiaoping Jiang, Lisa Rodriguez, Vadryn Pierre, Youwei Bi, Jiang Liu, Jeanne Fourie Zirkelbach, Anuja Patel, Kirsten B. Goldberg, Amy E. McKee, Patricia Keegan, Richard Pazdur Tags: Hepatobiliary, Regulatory Issues: FDA Source Type: research

Decision‐Making Capacity for Chemotherapy and Associated Factors in Newly Diagnosed Patients with Lung Cancer
Conclusion.A substantial proportion of patients diagnosed with lung cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision‐making frameworks to act in the best interest of patients.Implications for Practice.Decision‐making capacity is the cornerstone of clinical practice. A substantial proportion of patients with cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision‐making frameworks to act in the best interest of patients. (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Asao Ogawa, Kyoko Kondo, Hiroyuki Takei, Daisuke Fujisawa, Yuichiro Ohe, Tatsuo Akechi Tags: Lung Cancer, Geriatric Oncology Source Type: research

Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010–2014
Conclusion.In this contemporary, population‐based study of women with MBC, HER2 but not HR status was associated with improved survival. Survival was similar between HER2 positive MBC and HER2 positive IDC. This suggests HER2 positive MBC is responsive to HER2‐directed therapy, a finding that may offer insights for additional therapeutic approaches to MBC.Implications for Practice.This population‐based study reports recent outcomes, by receptor status, for women with metaplastic breast cancer. Survival in metaplastic breast cancer is not impacted by hormone receptor status. To the authors' knowledge, this is the firs...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Mary C. Schroeder, Priya Rastogi, Charles E. Geyer Jr., Lance D. Miller, Alexandra Thomas Tags: Breast Cancer Source Type: research

Fertility‐Sparing Treatment of Endometrial Cancer with Initial Infiltration of Myometrium by Resectoscopic Surgery: A Pilot Study
AbstractThree women with a well‐differentiated grade 1 endometrioid adenocarcinoma of the endometrium with minimal myometrial infiltration were treated with hysteroscopic resection and hormone therapy. The presence of myometrial infiltration has often been mentioned as an exclusion criterion for conservative management in young patients because of worsening cancer prognosis. The subsequent 5‐year follow‐up and the pregnancies achieved may confirm the choice of this temporary treatment and indicate a new option for fertility‐sparing treatment in highly motivated patients. (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Paolo Casadio, Francesca Guasina, Roberto Paradisi, Concetta Leggieri, Giacomo Caprara, Renato Seracchioli Tags: Gynecologic Oncology Brief Communications Source Type: research

Trastuzumab Plus Pertuzumab Resistance Does Not Preclude Response to Lapatinib Plus Trastuzumab in HER2‐Amplified Colorectal Cancer
AbstractHuman epidermal growth factor 2 (HER2) amplification represents a distinct molecular subgroup of colorectal cancers that is associated with anti‐epidermal growth factor receptor resistance and sensitivity to dual HER2 targeting. Although clinical trials have reported activity for trastuzumab/pertuzumab and trastuzumab/lapatinib combinations, there are no reports on lapatinib plus trastuzumab activity after resistance to trastuzumab plus pertuzumab. Presented are three cases of HER2 amplified colorectal cancer that developed acquired refractoriness to trastuzumab pertuzumab with subsequent clinical benefit to lapa...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Marwan G. Fakih Tags: Gastrointestinal Cancer Brief Communications Source Type: research

Therapeutic Anticoagulation in Patients with Primary Brain Tumors or Secondary Brain Metastasis
AbstractPatients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagul...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Richard J. Lin, David L. Green, Gunjan L. Shah Tags: Lung Cancer, Neuro-Oncology, Symptom Management and Supportive Care Source Type: research

Pre‐ and Postoperative Chemotherapy in Localized Extremity Soft Tissue Sarcoma: A European Organization for Research and Treatment of Cancer Expert Survey
Conclusion.Due to lacking evidence on the utility of pre‐ and postoperative chemotherapy in localized extremity STS, treatment strategies vary considerably among European experts. The majority recommended neoadjuvant chemotherapy for marginally resectable grade 2–3 tumors; the majority did not recommend postoperative chemotherapy in any setting.Implications for Practice.The management of localized extremity soft tissue sarcomas (STS) is challenging and the role of pre‐ and postoperative chemotherapy is unclear and debated among experts. This study analyzed the decision‐making process among 12 European experts o...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Christian Rothermundt, Galina F. Fischer, Sebastian Bauer, Jean-Yves Blay, Viktor Grunwald, Antoine Italiano, Bernd Kasper, Attila Kollar, Lars H. Lindner, Aisha Miah, Stefan Sleiȷfer, Silvia Stacchiotti, Paul Martin Putora Tags: Review, Sarcomas Source Type: research

Bendamustine plus Rituximab Versus R‐CHOP as First‐Line Treatment for Patients with Follicular Lymphoma Grade 3A: Evidence from a Multicenter, Retrospective Study
Conclusion.R‐B as a first‐line treatment of FL3A is better tolerated than R‐CHOP and seems to induce more profound responses, leading to a significantly lower relapse rate and prolonged PFS. Therefore, R‐B is a valid treatment option for FL grade 3A.Implications for Practice.Rituximab plus bendamustine (R‐B) has shown to be less toxic and more effective than rituximab, cyclophosphamide, doxorubicin, and prednisone (R‐CHOP) in follicular lymphoma grade 3A. Although both regimens can induce a complete remission in>95% of patients, relapses occur more frequently after R‐CHOP than R‐B, leading to a significa...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Patrizia Mondello, Normann Steiner, Wolfgang Willenbacher, Claudio Cerchione, Davide Nappi, Endri Mauro, Simone Ferrero, Salvatore Cuzzocrea, Michael Mian Tags: Lymphoma Hematologic Malignancies Source Type: research

Barriers and Explanatory Mechanisms of Delays in the Patient and Diagnosis Intervals of Care for Breast Cancer in Mexico
Conclusion.Our findings support the relevance of strengthening early cancer diagnosis strategies, especially the improvement of quality of primary care and expedited referral routes to cancer services.Implications for Practice.This study's findings suggest that policy in low‐ and middle‐income countries (LMICs) should be directed toward reducing delays in diagnosis, before the implementation of mammography screening programs. The results suggest several factors susceptible to early diagnosis interventions. To reduce patient delays, the usually proposed intervention of awareness promotion could better work in LMIC conte...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Karla Unger-Saldana, Daniel Ventosa-Santaularia, Alfonso Miranda, Guillermo Verduzco-Bustos Tags: Breast Cancer, Global Health and Cancer Source Type: research

Patient‐Reported Comorbidity and Survival in Older Adults with Cancer
Conclusion.Comorbid conditions in older adults with cancer are highly prevalent and associated with all‐cause mortality, particularly those conditions that impair function. Routine comorbidity assessment should be included in clinical trials and can be measured via a simple one‐page patient‐reported questionnaire.Implications for Practice.In order to optimize and personalize the care of older adults with cancer, systematic measurement of comorbidities is necessary in both clinical trials and routine practice. Patient‐reported comorbid conditions in older adults with cancer are highly prevalent and are associated wi...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Grant R. Williams, Allison M. Deal, Jennifer L. Lund, YunKyung Chang, Hyman B. Muss, Mackenzi Pergolotti, Emily J. Guerard, Shlomit Strulov Shachar, Yue Wang, Kelly Kenzik, Hanna K. Sanoff Tags: Geriatric Oncology Source Type: research

Neuroendocrine Tumor Heterogeneity Adds Uncertainty to the World Health Organization 2010 Classification: Real‐World Data from the Spanish Tumor Registry (R‐GETNE)
Conclusion.Substantial clinical heterogeneity is observed within G2 and G3 GEP‐NENs. The WHO 2010 classification can be improved by including the additive effect of histological differentiation and the proliferation index.Implications for Practice.Gastroenteropancreatic neuroendocrine neoplasms are tumors of widely variable clinical behavior, roughly stratified by the World Health Organization (WHO) 2010 classification into three subgroups based on proliferation index. Real‐world data from 2,813 patients of the Spanish Registry RGETNE demonstrated substantial clinical heterogeneity within grade (G) 2 and G3 neuroendocr...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Barbara Nunez-Valdovinos, Alberto Carmona-Bayonas, Paula Jimenez-Fonseca, Jaume Capdevila, Angel Castano-Pascual, Marta Benavent, Jose Javier Pi Barrio, Alex Teule, Vicente Alonso, Ana Custodio, Monica Marazuela, Angel Segura, Adolfo Beguiristain, Marta L Tags: Gastrointestinal Cancer Source Type: research

Molecular Biomarkers of Primary and Acquired Resistance to T‐Cell‐Mediated Immunotherapy in Cancer: Landscape, Clinical Implications, and Future Directions
AbstractThe emergence of immunotherapy has revolutionized cancer treatment in recent years. Inhibitors of immune checkpoints, including antibodies against cytotoxic T‐lymphocyte‐associated protein 4, programmed cell death protein 1, and programmed death ligand 1, have demonstrated notable efficacy in certain advanced cancers. Unfortunately, many patients do not benefit from these therapies and either exhibit primary resistance to treatment or develop acquired mechanisms of resistance after initially responding to therapy. Here, we review the genomic and immune traits that may promote resistance to T‐cell‐mediated i...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Young Kwang Chae, Michael S. Oh, Francis J. Giles Tags: Review, Precision Medicine, Cancer Diagnostics and Molecular Pathology Source Type: research

Safety Profile of Biosimilar Filgrastim (Zarzio/Zarxio): A Combined Analysis of Phase III Studies
AbstractBackground.Evaluation of adverse events (AEs) in pivotal registration trials and ongoing postmarketing surveillance is important for all biologics, including biosimilars. A combined analysis of two pivotal registration studies was performed to strengthen evidence on safety for biosimilar filgrastim EP2006 in patients with breast cancer receiving myelosuppressive chemotherapy, a sensitive clinical setting to confirm biosimilarity of filgrastim.Materials and Methods.Data were combined from two phase III studies of biosimilar filgrastim EP2006. The U.S. registration study was a randomized, double‐blind comparison of...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Nadia Harbeck, Pere Gascon, Andriy Krendyukov, Nadȷa Hoebel, Sreekanth Gattu, Kimberly Blackwell Tags: New Drug Development and Clinical Pharmacology, Breast Cancer Academia ‐ Pharma Intersect: Breast Cancer Source Type: research

Phase I Trial of a Tablet Formulation of Pilaralisib, a Pan‐Class I PI3K Inhibitor, in Patients with Advanced Solid Tumors
Conclusion.Pilaralisib tablets were associated with a favorable safety profile and preliminary antitumor activity. MTD was not determined. The recommended phase II dose for pilaralisib tablets, based on PK data, was 400 mg once daily. (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Gerald Edelman, Jordi Rodon, Joanne Lager, Christelle Castell, Jason Jiang, Eliezer M. Van Allen, Nikhil Wagle, Neal I. Lindeman, Lynette M. Sholl, Geoffrey I. Shapiro Tags: Lymphoma, Chinese Edition, Clinical Trial Results Source Type: research

Chemoprevention in Patients with Peutz‐Jeghers Syndrome: Lessons Learned
Conclusion.Due to accrual problems, no conclusions can be drawn about the value of everolimus in PJS treatment, questioning the feasibility of this agent for chemoprevention. (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Justin de Brabander, Ferry A.L.M. Eskens, Susanne E. Korsse, Evelien Dekker, Pieter Dewint, Monique E. van Leerdam, Susanne van Eeden, Heinz-Josef Klumpen Tags: Chinese Edition, Clinical Trial Results, Gastrointestinal Cancer Source Type: research

A Phase I Dose‐Escalation Study of Clofarabine in Patients with Relapsed or Refractory Low‐Grade or Intermediate‐Grade B‐Cell or T‐Cell Lymphoma
Conclusion.In this study, weekly administration of clofarabine was demonstrated to be safe and associated with minimal hematologic toxicity at doses ranging from 10–40 mg/m2. In prior studies when dosed daily for 5 consecutive days, the MTD was shown to be 4 mg/m2. Weekly dosing within this dose range did not result in dose modifications, and the MTD was not reached. Clinical efficacy was observed in one patient with CTCL who was treated in the lowest‐dose cohort. (Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Francine Marie Foss, Terri Parker Tags: Lymphoma, Chinese Edition, Clinical Trial Results Source Type: research

The Perils of Single‐Site Genetic Testing for Hereditary Cancer Syndromes in the Era of Next‐Generation Sequencing
AbstractA challenge in counseling patients with a family history suggesting a hereditary cancer syndrome is deciding which genetic tests or panels to order. In this article, we discuss the identification of multiple familial mutations through genetic counseling and panel testing. For patients meeting National Comprehensive Cancer Network criteria for clinical genetic testing, providers should consider expanded panels to provide a more complete assessment of one's genetic risk. The continued use of expanded panel testing in the clinical setting will help inform optimal management of cancer patients, as well as the managemen...
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Nicole Casasanta, Elizabeth Stark, Allison McHenry, Tara Biagi, Rebecca Kaltman Tags: Precision Medicine, Cancer Diagnostics and Molecular Pathology Precision Medicine Clinic: Molecular Tumor Board Source Type: research

Early Steps in the Value of Cancer Care—Many Paths Remain Unexplored
(Source: The Oncologist)
Source: The Oncologist - April 12, 2018 Category: Cancer & Oncology Authors: Daniel A. Goldstein, Carlo La Vecchia, Bernardo H.L. Goulart Tags: Health Outcomes and Economics of Cancer Care, Value in Cancer Care Series Editorial Source Type: research

FDA Approval Summary: Tocilizumab for Treatment of Chimeric Antigen Receptor T Cell-Induced Severe or Life-Threatening Cytokine Release Syndrome.
Abstract On August 30, 2017, the U.S. Food and Drug Administration approved Actemra (tocilizumab, Genentech, Inc., South San Francisco, CA) for the treatment of severe or life-threatening chimeric antigen receptor (CAR) T cell-induced cytokine release syndrome (CRS) in adults and in pediatric patients 2 years of age and older. The approval was based on a retrospective analysis of data for patients who developed CRS after treatment with CTL019 and KTE-C19 on prospective clinical trials. Evaluable patients had been treated with intravenous tocilizumab 8 mg/kg (12 mg/kg for patients
Source: The Oncologist - April 5, 2018 Category: Cancer & Oncology Authors: Le RQ, Li L, Yuan W, Shord SS, Nie L, Habtemariam BA, Przepiorka D, Farrell AT, Pazdur R Tags: Oncologist Source Type: research

Value of Supportive Care Pharmacogenomics in Oncology Practice.
Abstract Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug response-otherwise known as pharmacogenomics-is well documented and directly influences an individual patient's respon...
Source: The Oncologist - April 5, 2018 Category: Cancer & Oncology Authors: Patel JN, Wiebe LA, Dunnenberger HM, McLeod HL Tags: Oncologist Source Type: research

Comprehensive Computed Tomography Radiomics Analysis of Lung Adenocarcinoma for Prognostication.
CONCLUSION: Radiomics approach in lung adenocarcinoma enables utilization of the full potential of medical imaging and has potential to improve prognosis assessment in clinical oncology. IMPLICATIONS FOR PRACTICE: Two radiomics features were prognostic for lung cancer survival at multivariate analysis: (a) maximum value of the outer one third of the tumor reflects the tumor microenvironment and (b) size zone variance represents the intratumor heterogeneity. Therefore, a radiomics approach in lung adenocarcinoma enables utilization of the full potential of medical imaging and could play a larger role in clinical oncolo...
Source: The Oncologist - April 5, 2018 Category: Cancer & Oncology Authors: Lee G, Park H, Sohn I, Lee SH, Song SH, Kim H, Lee KS, Shim YM, Lee HY Tags: Oncologist Source Type: research

Hybrid Capture-Based Tumor Sequencing and Copy Number Analysis to Confirm Origin of Metachronous Metastases in BRCA1-Mutant Cholangiocarcinoma Harboring a Novel YWHAZ-BRAF Fusion.
We report the case of a patient with a germline BRCA1 mutation who presented with a cholangiocarcinoma driven by the novel YWHAZ-BRAF fusion. Hybrid capture-based DNA sequencing and copy number analysis performed as part of clinical care demonstrated that two later-occurring tumors were clonally derived from the primary cholangiocarcinoma rather than distinct new primaries, revealing an unusual pattern of late metachronous metastasis. We discuss the clinical significance of these genetic alterations and their relevance to therapeutic strategies. KEY POINTS: Hybrid capture-based next-generation DNA sequencing assays ca...
Source: The Oncologist - April 5, 2018 Category: Cancer & Oncology Authors: Lim HC, Montesion M, Botton T, Collisson EA, Umetsu SE, Behr SC, Gordan JD, Stephens PJ, Kelley RK Tags: Oncologist Source Type: research

The Role of Notch3 in Cancer.
Abstract The Notch family is a highly conserved gene group that regulates cell-cell interaction, embryogenesis, and tissue commitment. This review article focuses on the third Notch family subtype, Notch3. Regulation via Notch3 signaling was first implicated in vasculogenesis. However, more recent findings suggest that Notch3 signaling may play an important role in oncogenesis, tumor maintenance, and resistance to chemotherapy. Its role is mainly oncogenic, although in some cancers it appears to be tumor suppressive. Despite the wealth of published literature, it remains relatively underexplored and requires furth...
Source: The Oncologist - April 5, 2018 Category: Cancer & Oncology Authors: Aburjania Z, Jang S, Whitt J, Jaskula-Stzul R, Chen H, Rose JB Tags: Oncologist Source Type: research

Administration of the Tablet Formulation of Olaparib in Patients with Ovarian Cancer: Practical Guidance and Expectations.
Abstract Olaparib is a poly(ADP-ribose) polymerase enzyme inhibitor that is approved for use in patients with advanced ovarian cancer (OC) and genetic BRCA1/2 mutations who have received three or more prior lines of chemotherapy for maintenance treatment of recurrent OC that is in response to platinum-based chemotherapy regardless of BRCA mutation status and for human epidermal growth receptor factor 2-negative metastatic breast cancer with deleterious or suspected deleterious germline BRCA mutations who have previously been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting. Because ola...
Source: The Oncologist - March 28, 2018 Category: Cancer & Oncology Authors: Moore KN, Birrer MJ Tags: Oncologist Source Type: research

Phase I Trial of a Tablet Formulation of Pilaralisib, a Pan-Class I PI3K Inhibitor, in Patients with Advanced Solid Tumors.
CONCLUSION: Pilaralisib tablets were associated with a favorable safety profile and preliminary antitumor activity. MTD was not determined. The recommended phase II dose for pilaralisib tablets, based on PK data, was 400 mg once daily. PMID: 29593099 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - March 28, 2018 Category: Cancer & Oncology Authors: Edelman G, Rodon J, Lager J, Castell C, Jiang J, Van Allen EM, Wagle N, Lindeman NI, Sholl LM, Shapiro GI Tags: Oncologist Source Type: research

Development and Validation of a Clinical Score for Cardiovascular Risk Stratification of Long-Term Childhood Cancer Survivors.
Abstract BACKGROUND: Long-term childhood cancer survivors (CCS) are at increased risk of adverse cardiovascular events; however, there is a paucity of risk-stratification tools to identify those at higher-than-normal risk. SUBJECTS, MATERIALS, AND METHODS: This was a population-based study using data from the Surveillance, Epidemiology, and End Results Program (1973-2013). Long-term CCS (age at diagnosis ≤19 years, survival ≥5 years) were followed up over a median time period of 12.3 (5-40.9) years. Independent predictors of cardiovascular mortality (CVM) were combined into a risk score, which was devel...
Source: The Oncologist - March 28, 2018 Category: Cancer & Oncology Authors: Oikonomou EK, Athanasopoulou SG, Kampaktsis PN, Kokkinidis DG, Papanastasiou CA, Feher A, Steingart RM, Oeffinger KC, Gupta D Tags: Oncologist Source Type: research

A Phase I Trial of the IGF-1R Antibody Ganitumab (AMG 479) in Combination with Everolimus (RAD001) and Panitumumab in Patients with Advanced Cancer.
CONCLUSION: The triplet regimen of ganitumab, everolimus, and panitumumab was associated with unacceptable toxicity. However, the doublet of ganitumab at 12 mg/kg every 2 weeks and everolimus five times weekly had an acceptable safety profile and demonstrated notable clinical activity in patients with refractory NSCLC and sarcoma. IMPLICATIONS FOR PRACTICE: This trial evaluated the maximum tolerated dose or recommended phase II dose and safety and tolerability of the ganitumab and everolimus doublet regimen followed by the ganitumab, everolimus, and panitumumab triplet regimen. Although the triplet regimen of ganituma...
Source: The Oncologist - March 23, 2018 Category: Cancer & Oncology Authors: Vlahovic G, Meadows KL, Hatch AJ, Jia J, Nixon AB, Uronis HE, Morse MA, Selim MA, Crawford J, Riedel RF, Zafar SY, Howard LA, O'Neill M, Meadows JJ, Haley ST, Arrowood CC, Rushing C, Pang H, Hurwitz HI Tags: Oncologist Source Type: research

Insights into the Psychology of Trauma Should Inform the Practice of Oncology.
PMID: 29567819 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Lawson KC, Lawson DH Tags: Oncologist 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/vin...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Ko R, Shukuya T, Okuma Y, Tateishi K, Imai H, Iwasawa S, Miyauchi E, Fujiwara A, Sugiyama T, Azuma K, Muraki K, Yamasaki M, Tanaka H, Takashima Y, Soda S, Ishimoto O, Koyama N, Morita S, Kobayashi K, Nukiwa T, Takahashi K, North East Japan Study Group Tags: Oncologist Source Type: research

Costs of Cancer Care Across the Disease Continuum.
CONCLUSION: Considerable differences exist in expenditures across phases of cancer care. By understanding the drivers of such payment variations across patient and tumor characteristics, we can inform efforts to decrease payments and increase quality, thereby reducing the burden of cancer care. IMPLICATIONS FOR PRACTICE: Considerable differences exist in expenditures across phases of cancer care. There are further differences by varying patient characteristics. Understanding the drivers of such payment variations across patient and tumor characteristics can inform efforts to decrease costs and increase quality, thereb...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Kaye DR, Min HS, Herrel LA, Dupree JM, Ellimoottil C, Miller DC Tags: Oncologist 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 responses o...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Odagiri T, Morita T, Aoyama M, Kizawa Y, Tsuneto S, Shima Y, Miyashita M, J‐HOPE Group Tags: Oncologist Source Type: research

Cervical Cancer in Ethiopia: The Effect of Adherence to Radiotherapy on Survival.
Abstract BACKGROUND: 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 multiv...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Moelle U, Mathewos A, Aynalem A, Wondemagegnehu T, Yonas B, Begoihn M, Addissie A, Unverzagt S, Jemal A, Thomssen C, Vordermark D, Kantelhardt EJ Tags: Oncologist Source Type: research

Serial Troponin for Early Detection of Nivolumab Cardiotoxicity in Advanced Non-Small Cell Lung Cancer Patients.
CONCLUSION: Tn+ may occur in NSCLC patients treated with nivolumab, but in most cases it does not indicate nivolumab cardiotoxicity. In some cases, however, a careful interpretation of troponin alteration, especially at the beginning of therapy, enables identification of subclinical myocarditis, thus allowing early cardiac treatment. IMPLICATIONS FOR PRACTICE: Myocarditis is a rare but serious adverse event of immune checkpoint blockade with nivolumab, which needs to be recognized as soon as possible. This article suggests that troponin, a user-friendly biomarker of myocardial cytotoxicity, might be useful for early d...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Sarocchi M, Grossi F, Arboscello E, Bellodi A, Genova C, Dal Bello MG, Rijavec E, Barletta G, Rossi G, Biello F, Ghigliotti G, Canepa M, Mussap M, Brunelli C, Spallarossa P Tags: Oncologist Source Type: research

The Emerging Impact of Social Media on Cancer Patient Education in Japan.
PMID: 29567825 [PubMed - as supplied by publisher] (Source: The Oncologist)
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Sasaki Y, Ueno NT Tags: Oncologist Source Type: research

Treatment and Survival of Patients with Colon Cancer Aged 80 Years and Older: A EURECCA International Comparison.
CONCLUSION: There is substantial variation in the rate of treatment and survival between countries for patients with colon cancer aged 80 years or older. Despite higher prescription of adjuvant chemotherapy, poorer survival outcomes were observed in Belgium. No clear linear pattern between the proportion of chemotherapy and better adjusted relative survival was observed. IMPLICATIONS FOR PRACTICE: With the increasing growth of the older population, clinicians will be treating an increasing number of older patients diagnosed with colon cancer. No clear linear pattern between adjuvant chemotherapy and better adjusted re...
Source: The Oncologist - March 22, 2018 Category: Cancer & Oncology Authors: Vermeer NCA, Claassen YHM, Derks MGM, Iversen LH, van Eycken E, Guren MG, Mroczkowski P, Martling A, Johansson R, Vandendael T, Wibe A, Moller B, Lippert H, Portielje JEA, Liefers GJ, Peeters KCMJ, van de Velde CJH, Bastiaannet E Tags: Oncologist Source Type: research

Hybrid Capture-Based Comprehensive Genomic Profiling Identifies Lung Cancer Patients with Well-Characterized Sensitizing Epidermal Growth Factor Receptor Point Mutations That Were Not Detected by Standard of Care Testing.
CONCLUSION: CGP, even when applied to low tumor purity clinical-grade specimens, can detect well-known EGFR pm in NSCLC patients that would otherwise not be detected by SOC testing. Taken together with EGFR exon 19 deletions, over 20% of patients who are positive for EGFR-activating mutations using CGP are previously negative by SOC EGFR mutation testing, suggesting that thousands of such patients per year in the U.S. alone could experience improved clinical outcomes when hybrid capture-based CGP is used to inform therapeutic decisions. IMPLICATIONS FOR PRACTICE: This study points out that genomic profiling, as based ...
Source: The Oncologist - March 14, 2018 Category: Cancer & Oncology Authors: Suh JH, Schrock AB, Johnson A, Lipson D, Gay LM, Ramkissoon S, Vergilio JA, Elvin JA, Shakir A, Ruehlman P, Reckamp KL, Ou SI, Ross JS, Stephens PJ, Miller VA, Ali SM Tags: Oncologist Source Type: research

Weekly Docetaxel, Cisplatin, and Cetuximab in Palliative Treatment of Patients with Squamous Cell Carcinoma of the Head and Neck.
The objective of this study was to establish the response rate, progression-free survival (PFS) and overall survival (OS), and safety profile of weekly docetaxel, platinum, and cetuximab (TPC) in patients with relapsed or metastatic squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS: Twenty-nine patients with metastatic or recurrent SCCHN with an Eastern Cooperative Oncology Group (ECOG) performance status
Source: The Oncologist - March 14, 2018 Category: Cancer & Oncology Authors: Trieu V, Pinto H, Riess JW, Lira R, Luciano R, Coty J, Boothroyd D, Colevas AD Tags: Oncologist Source Type: research

The Implementation and First-Round Results of a Community-Based Colorectal Cancer Screening Program in Shanghai, China.
CONCLUSION: The screening program achieved great progress, especially on initial screening completion and CRC early stage rate, although particular intervention is still needed to improve the compliance of colonoscopy. IMPLICATIONS FOR PRACTICE: Due to socioeconomic transitions and lifestyle changes, colorectal cancer is now becoming one of the most common cancers in developing countries, as it is in developed countries. While most developed countries have now initiated national colorectal cancer screening programs based on recommended country-specific colorectal cancer screening guidelines, colonoscopy has become the...
Source: The Oncologist - March 14, 2018 Category: Cancer & Oncology Authors: Gong Y, Peng P, Bao P, Zhong W, Shi Y, Gu K, Zheng Y, Wu C, Cai S, Xu Y, Sheng J, Wu F Tags: Oncologist Source Type: research