Precision Medicine Clinic: Molecular Tumor Board
This article describes the case of a 52-year-old male who was diagnosed with anaplastic thyroid cancer. The patient harbored a V600E mutation in BRAF and a PD-L1 positivity in both the tumor and the tumor infiltrating lymphocytes. Diagnosis and treatment details are reported.
Clinical Trial Results
A Phase II Study with Lead-In Safety Cohort of 5-Fluorouracil, Oxaliplatin, and Lapatinib in Combination with Radiation Therapy as Neoadjuvant Treatment for Patients with Localized HER2-Positive Esophagogastric Adenocarcinomas
Pregabalin for the Prevention of Oxaliplatin-Induced Painful Neuropathy: A Randomized, Double-Blind Trial
A Phase II Trial Evaluating the Safety of Rapid Infusion of Ofatumumab in Patients with Previously Treated Chronic Lymphocytic Leukemia
Phase II Trial of Sorafenib in Combination with Capecitabine in Patients with Hepatocellular Carcinoma: INST 08-20
Efficacy and Safety of Pertuzumab and Trastuzumab Administered in a Single Infusion Bag, Followed by Vinorelbine: VELVET Cohort 2 Final Results
The final efficacy and safety results are reported for the VELVET Cohort 2 trial, which investigated the coinfusion of pertuzumab and trastuzumab in a single infusion bag, followed by vinorelbine.
Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors
For most breast cancer survivors experiencing aromatase inhibitor-associated arthralgia (AIAA), pharmacological remedies such as analgesics and antidepressants provide little or no joint symptom relief, and these medications have their own adverse side effects. There is a need to identify effective, easy-to-use, sustainable, and safe alternative or adjunctive approaches to AIAA management. This article describes an evidence-based walking program that is effective in reducing symptoms in adults with arthritis and investigates whether the program could have similar benefits for women experiencing AIAA.
Cancer Diagnostics and Molecular Pathology
Clinical Application of Targeted Deep Sequencing in Solid-Cancer Patients; Utility of Targeted Deep Sequencing for Biomarker-Selected Clinical Trial
Advances in sequencing technologies and improved algorithms for detecting specific molecular aberrations make it possible to perform biomarker-driven clinical trials. The analytical sensitivity and clinical validity have not yet been demonstrated in a large cohort. This article describes the implementation of a targeted-sequencing panel in a precision oncology clinic and the feasibility of a clinic-based molecular screening program.
This study aimed to determine whether the TERT promoter methylation differs between gastrointestinal cancer and normal gastrointestinal tissues and, if so, whether the TERT promoter methylation analysis in stool is useful for screening of gastrointestinal cancer.
Association of Pre-Chemotherapy Peripheral Blood Pro-Inflammatory and Coagulation Factors with Physical Function in Women with Breast Cancer
Breast cancer is a disease associated with aging. Before initiation of chemotherapy, an assessment of functional reserve is needed; however, simple performance assessment scores may not reflect the diverse nature of physical function and risk of toxicity among older adults. The focus of this article is on understanding the association between pre-chemotherapy biomarkers (IL-6, CRP, and D-dimer) and measures of physical function.
Global Health and Cancer
Implementation of a School-Based Educational Program to Increase Breast Cancer Awareness and Promote Intergenerational Transmission of Knowledge in a Rural Mexican Community
Breast cancer mortality rates in low- and middle-income countries are higher than in the developed world. Programs aimed at enhancing education and awareness of breast cancer are a critical strategy to overcoming barriers to timely diagnosis in these countries. This article reports a program designed to educate adolescents on breast cancer with the end goal of promoting intergenerational transmission of breast cancer-related knowledge to their older female relatives.
An increasing number of cancer patients appears to seek a second opinion about diagnosis or treatment. This systematic review examines the available empirical evidence on patient-initiated second opinions in oncology and provides recommendations to clinicians for optimal communication about second opinions.
New Drug Development and Clinical Pharmacology
In the field of oncology, most drugs are administered in a body–size-based dosing schedule instead of a fixed dose for all patients. This article presents the advantages of fixed dosing of monoclonal antibodies, arguing in favor of fixed dosing schemes for all currently approved antibodies in oncology.
Pulmonary Function Changes After Radiotherapy for Lung or Esophageal Cancer: A Systematic Review Focusing on Dose-Volume Parameters
Radiation-induced lung toxicity remains a challenge in thoracic radiotherapy. This systematic review focuses on radiation dose-volume histogram parameters for lung and heart as predictors for changes in FEV1 and diffusion capacity after radiotherapy for lung or esophageal cancer.
Localized Adult Ewing Sarcoma: Favorable Outcomes with Alternating Vincristine, Doxorubicin, Cyclophosphamide, and Ifosfamide, Etoposide (VDC/IE)-Based Multimodality Therapy
Although typically considered a pediatric disease, Ewing sarcoma can occur adults. Current standard treatment for localized Ewing sarcoma is a multimodality approach, combining chemotherapy and local therapy consisting of surgery and/or radiation therapy. This article evaluates outcomes for adults with localized Ewing sarcoma treated exclusively with cyclophosphamide, doxorubicin, and vincristine followed by ifosfamide and etoposide in combination with local therapy.
Ewing sarcoma is rare in adults, and there are no dedicated clinical trials in the adult population. This article reviews the results of therapy with vincristine, ifosfamide, and doxorubicin in the multidisciplinary treatment of adults with Ewing sarcoma.
Symptom Management and Supportive Care
A Predictive Score for Thrombosis Associated with Breast, Colorectal, Lung, or Ovarian Cancer: The Prospective COMPASS–Cancer-Associated Thrombosis Study
The COMPASS-CAT study was undertaken in outpatients with breast, colon, lung, or ovarian cancer. The aim of the study was to identify the most relevat risk factors for symptomatic thromboembolism and to develop a risk assessment model applicable to patients after the initiation of anticancer treatment.
Immune-Related Adverse Events as a Biomarker in Non-Melanoma Patients Treated with Programmed Cell Death 1 Inhibitors
Immune checkpoint inhibitors are a novel class of immunotherapeutic agents being used in clinical practice for many advanced malignancies. Checkpoint blockade targeting the programmed cell death 1 receptor or its primary ligand with pembrolizumab, nivolumab, or atezolizumab has received U.S. Food and Drug Administration approval for the treatment ofmetastatic melanoma, non-small cell lung cancer, renal cell carcinoma, Hodgkin's lymphoma, head and neck squamous cell carcinoma, and urothelial carcinoma. Considering that checkpoint blockade treatments now extend to tumor types beyond melanoma, a study was conducted to evaluate whether the development of immune-related adverse events correlates with treatment response in other cancer subtypes.
Narratives in Oncology
Originally presented as part of the 20th Anniversary of Palliative Care at Massachusetts General Hospital, this narrative is one patient's story of stage IV cancer.