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Psycho-Oncology and the Relevance of a Biopsychosocial Screening ProgramRoutine biopsychosocial screening of a patient with metastatic renal cell cancer at the Centro de Câncer de Brasília improved symptom management and shrunk costs for both the patient and her caregivers.
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Predictive Biomarkers for Immunotherapy Response Beyond PD-1/PD-L1ABSTRACT Advances in immuno-oncology over the last several years have led to FDA approvals of novel agents. As our understanding of immune response and its checkpoints has evolved, further advances have been made in treatment for several cancer types. To predict a response to immunotherapy, the initial biomarkers used were expression of the PD-1 receptor and PD-L1, as assessed by immunohistochemistry. More recently, predictive biomarkers have included microsatellite instability, DNA mismatch repair, and tumor mutational burden. Although these markers may be clinically relevant in predicting an immunotherapy response, cancer immunotherapy fails some patients. Improved understanding of the human immune system is necessary, as is a careful evaluation of the methods used to predict and assess response to Immuno-oncology treatments. With the application of therapeutic immune-modulating agents, more comprehensive assays, and associated bioinformatics tools to accurately assess the tumor microenvironment, we may better predict responses to immuno-oncology agents and the ever-increasing complexity of their clinical use.
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Treatment Response and Duration of Therapy in Transplant-Ineligible NDMMClosing out their module on transplant-ineligible NDMM management, expert panelists consider best practices regarding duration of therapy and adjustments to drug regimens.
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Triplet Induction Chemotherapy Improves FFS in Nasopharyngeal Carcinoma Vs Doublet RegimenPatients with stage IVA to IVB nasopharyngeal carcinoma experienced an improvement in failure-free survival following treatment with paclitaxel, cisplatin, and capecitabine for 2 cycles vs 2 cycles of cisplatin and fluorouracil.
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Future Directions in Graft vs Host Disease ManagementClosing out their panel on GVHD management, expert hematologist/oncologists share their hope for future evolution in the treatment landscape.
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Exploring the Changing Diagnostic Criteria of Gorlin-Goltz Syndrome: A Case ReportA case study by Sahith Kumar Shetty, BDS, MDS, et al reviews the need for a multidisciplinary approach to the treatment of patients with Gorlin-Goltz syndrome.
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Multiple Myeloma: Unmet Needs and Future PerspectivesClosing out their discussion on the management of multiple myeloma, experts from the Moffit Cancer Center highlight key unmet needs and future directions in care.
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Future Perspectives and Unmet Needs in CLLThe panelists conclude their discussion by offering future perspectives on CLL treatment, emphasizing remaining areas of unmet needs in the treatment landscape.
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Elacestrant Bests Standard of Care in PFS in ER Positive/HER2-Negative Metastatic Breast CancerPatients with ER-positive/HER2-negative metastatic breast cancer had improved progression-free survival when treated with elacestrant compared with standard of endocrine therapy.
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Christian Buske, MD, on the Influence of CAR T-Cells Being Presented at ASHThe lymphoma expert spoke about the research being presented at the 2020 ASH Annual Meeting and what he believes has the potential to be most influential for treating this patient population.
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Medical World News® Inside the Practice: CancerNetwork® and Duke Herrell on a Novel Suturing Technique for Transurethral AnastomosisCancerNetwork® shares its latest investigation into novel practices for rendering surgical management of prostate cancer from experts at Vanderbilt Institute for Surgery and Engineering.
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The Future of BRAF-Mutant mCRC ManagementChristina Wu, MB, BCh, MD, closes the program by expressing the necessity of enrolling patients with BRAF-mutant metastatic colorectal cancer in clinical trials, highlighting a second-line study led by the Southwest Oncology Group, new BRAF inhibitors, early phase studies at the Mayo Clinic, and an exciting study in the adjuvant setting.
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Utility of the 21-Gene Recurrence Score in Node-Positive Breast CancerABSTRACT The 21-gene Recurrence Score (RS) assay has been validated as both a prognostic and predictive tool in node-negative (pN0), estrogen receptor–positive (ER+), HER2-negative (HER2–) breast cancer. A large body of evidence supports the clinical utility of the RS in the node positive (pN+) population as well. Retrospective analyses of archived tissue from multiple clinical trials have found the RS to be prognostic in both endocrine therapy (ET)-treated and chemotherapy-treated patients with pN+ disease. Distribution of RS results in pN+ patients have also been consistent with those of pN0 populations. Data from the SWOG 8814 trial and large population-based registries further support the prognostic and potential predictive value of the RS. Specifically, patients with 1 to 3 positive nodes and RS less than 18 derived negligible benefit from adjuvant chemotherapy in these studies. In the prospective West German Study Group PlanB and ADAPT trials, pN+ patients with RS less than 11 and RS ≤25, respectively, who were treated with ET alone experienced excellent outcomes. Finally, 5-year results of the RxPONDER clinical trial randomizing patients with 1 to 3 positive nodes and RS ≤25 to ET alone vs ET plus chemotherapy confirmed an absence of chemotherapy benefit in postmenopausal patients. Clinical practice guidelines support use of the RS in the pN+, ER+/HER2– population, and many institutions have adopted the RS to guide clinical decision-making, resulting in a net reduction of adjuvant chemotherapy use. This review highlights the existing data supporting the prognostic and predictive ability of the RS in pN+ disease, current practice patterns related to RS use in this population, and emerging applications.
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Characterization of Blood-Based Molecular Profiling in Pancreatic AdenocarcinomaMolecular profiling is being explored in pancreatic adenocarcinoma as a tool to assist with early detection, prognosis, and patient selection in targeted therapy clinical trials.
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Polygenic Score May Offer Personalized Treatment Options for Pediatric AMLInvestigators used a patient-specific score to predict treatment outcomes in pediatric patients with acute myeloid leukemia, allowing them to identify who may benefit from higher-dose chemotherapy.
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Opsoclonus-Myoclonus–Associated Neuroblastoma With Bone Marrow Metastases: What Would Be the Best Treatment Option?In this clinical quandary, investigators determine how to best treat patients with opsoclonus-myoclonus–associated neuroblastoma with bone marrow metastases.
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Achieving Health Equity in Lung Cancer SurgeryRian M. Hasson Charles, MD, MPH, FACS, discusses advances in equitable lung cancer screening and her experiences as a woman in thoracic oncology.
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Telemedicine Use in Oncology PracticesABSTRACT Telemedicine (TM) will play an increasingly significant role in practices that diagnose cancers and treat patients. Although only a small percentage of oncologists currently use TM, many more will embrace this technology in the near future. Although TM has been available for several decades, it was the coronavirus disease 2019 pandemic that highlighted how useful the concept was for connecting and communicating not only with patients who live a significant distance away from their oncologist’s brick-and-mortar office, but with those who are homebound, for whatever reason. For instance, patients who have tested positive for coronavirus but who are not significantly symptomatic can be safely treated while they remain at home. One barrier to the widespread implementation of TM was lack of compensation for the time spent communicating with patients using audio-visual technology. As of March 2020, however, CMS has mandated that TM virtual visits and face-to-face visits have financial parity. This article will explore the process of implementing TM into an oncology practice with minimal time, energy, effort, and expense, as well as the concepts and the trends behind using TM to provide care for patients with cancer.
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Looking Ahead in the Multiple Myeloma Treatment LandscapeExperts from City of Hope close out their panel on multiple myeloma management by identifying unmet needs and sharing what excites them in the future evolution of the treatment landscape.
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QOL vs Survival Should be Considered Prior to Chemo in Geriatric TNBCFindings from a National Cancer Database analysis highlight no statistically significant differences in survival outcomes with chemotherapy for patients over 81 years old with triple-negative breast cancer compared with those who do not receive chemotherapy.
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Use of Immunotherapy in Patients With Cancer During the COVID-19 PandemicThis article discusses the potential implications of using checkpoint inhibitors during the COVID-19 pandemic.
