Volume 26, Issue 2, February 2021
Editorial
A Medical Pearl Harbor: Pandemic Uncovers Societal Fissures and Leadership Breaches
The Editors of The Oncologist remark on recent national events and call for new strategies for the New Year.
Precision Medicine Clinic: Molecular Tumor Board
Tumor Evolution in a Patient with Recurrent Endometrial Cancer and Synchronous Neuroendocrine Cancer and Response to Checkpoint Inhibitor Treatment
This case report highlights the importance of molecular testing for optimal therapy of complex synchronous tumors and the need for communication between surgical and medical oncologists in cases of high microsatellite instability cancer.
Clinical Trial Results
Multicenter Phase II Trial of Axitinib Monotherapy for Gemcitabine‐Based Chemotherapy Refractory Advanced Biliary Tract Cancer (AX‐BC Study)
A Phase II Clinical Trial of Pembrolizumab and Enobosarm in Patients with Androgen Receptor‐Positive Metastatic Triple‐Negative Breast Cancer
A Phase I Open‐Label Clinical Trial Evaluating the Therapeutic Vaccine hVEGF26–104/RFASE in Patients with Advanced Solid Malignancies
A Randomized Phase II Study of Sequential Eribulin Versus Paclitaxel Followed by FAC/FEC as Neoadjuvant Therapy in Patients with Operable HER2‐Negative Breast Cancer
Breast Cancer
Everolimus Plus Exemestane Treatment in Patients with Metastatic Hormone Receptor‐Positive Breast Cancer Previously Treated with CDK4/6 Inhibitor Therapy
The clinical benefit of everolimus and exemestane in patients previously treated with a CDK4/6 inhibitor is unknown. This study used real‐world data to investigate survival outcomes in such cases.
Breast Cancer‐Specific Mortality in Small‐Sized Tumor with Stage IV Breast Cancer: A Population‐Based Study
Clinical outcomes are highly variable in patients with metastatic breast cancer. This article analyzes breast cancer‐specific mortality according to tumor size, stratified by lymph node metastasis in stage IV breast cancer, using the SEER cancer database.
Community Outreach
Sex Representation in Clinical Trials Associated with FDA Cancer Drug Approvals Differs Between Solid and Hematologic Malignancies
Disparities in health care have come into sharp focus recently. This article assesses female representation in clinical trials and reports on the effect of policy changes to address underrepresentation and whether females were adequately represented within clinical trials that have recently led to FDA cancer drug approvals.
Endocrinology
Changes in Stage Distribution and Disease‐Specific Survival in Differentiated Thyroid Cancer with Transition to American Joint Committee on Cancer 8th Edition: A Systematic Review and Meta‐Analysis
This article evaluates recent revisions to the AJCC staging criteria for differentiated thyroid cancer.
Gastrointestinal Cancer
Efficacy of FOLFOX in Patients with Aggressive Pancreatic Neuroendocrine Tumors After Prior Capecitabine/Temozolomide
There is increasing evidence that well‐differentiated neuroendocrine tumors can become highly aggressive over time. This article assesses FOLFOX activity in a population of heavily pretreated patients with rapidly progressive pancreatic neuroendocrine tumors.
Extended RAS Analysis of the Phase III EPIC Trial: Irinotecan + Cetuximab Versus Irinotecan as Second‐Line Treatment for Patients with Metastatic Colorectal Cancer
This article analyzes outcomes of patients with RAS‐wild‐type metastatic colorectal cancer who received cetuximab plus irinotecan versus irinotecan alone in the EPIC trial.
Genitourinary Cancer
Tumor Frameshift Mutation Proportion Predicts Response to Immunotherapy in Mismatch Repair‐Deficient Prostate Cancer
Biomarkers of immune checkpoint inhibition sensitivity are needed. This article reports on genomic biomarkers that may predict response to anti‐PD1 therapy in prostate cancer.
Head and Neck Cancers
The Prognostic and Therapeutic Value of the Mutational Profile of Blood and Tumor Tissue in Head and Neck Squamous Cell Carcinoma
This article reports on the genomic landscape of circulating tumor DNA in head and neck squamous cell carcinoma and analyzes its prognostic significance and potential contribution to precision oncology treatment strategies alone and in combination with tumor DNA analysis.
Health Outcomes and Economics of Cancer Care
Cost‐Effectiveness of Pembrolizumab plus Axitinib Versus Sunitinib as First‐Line Therapy in Advanced Renal Cell Carcinoma in the U.S.
This article examines the cost‐effectiveness of pembrolizumab plus axitinib versus sunitinib in advanced renal cell carcinoma, with the goal of proposing the most cost‐effective strategy with clinical benefit for first‐line therapy in this patient population.
Hematologic Malignancies
Challenges and Opportunities in the Management of Diffuse Large B‐Cell Lymphoma in Older Patients
Diffuse large B‐cell lymphoma (DLBCL) is an aggressive but potentially curable cancer that mainly affects older individuals. This review presents recent advances in fitness stratification and therapy that have expanded curative options for older patients with DLBCL and future opportunities to improve outcomes in this population.
More Insights on the Use of γ‐Secretase Inhibitors in Cancer Treatment
Understanding the mechanism of γ‐secretase inhibitor (GSI)–induced cell death and the ability to accurately identify patients based on the activity of the pathway could improve the response to GSI therapy for the treatment of cancer. This article focuses on γ‐secretase inhibitors as a potential therapeutic target to treat T‐cell acute lymphoblastic leukemias and lymphomas.
Immuno-Oncology
A Pilot Study of Checkpoint Inhibitors in Solid Organ Transplant Recipients with Metastatic Cutaneous Squamous Cell Carcinoma
This article focuses on the safety and efficacy of immune checkpoint inhibitors in solid organ transplant recipients with advanced head and neck cutaneous squamous cell carcinoma who have failed attempts at immunosuppression minimization, as well as prior surgical, radiation therapy, and other systemic therapies.
Lung Cancer
Navigating Diagnostic and Treatment Decisions in Non‐Small Cell Lung Cancer: Expert Commentary on the Multidisciplinary Team Approach
This article highlights the value of a multidisciplinary approach to diagnosis and staging, treatment decision making, and adverse event management in non‐small cell lung cancer.
Regulatory Issues: FDA
FDA Approval Summary: Rucaparib for the Treatment of Patients with Deleterious BRCA‐Mutated Metastatic Castrate‐Resistant Prostate Cancer
This article reviews the data and basis for FDA accelerated approval of rucaparib for the first‐line treatment of patients with deleterious BRCA‐mutated metastatic castrate‐resistant prostate cancer.
Symptom Management and Supportive Care
Serial Assessment of Depression and Anxiety by Patients and Providers in Women Receiving Chemotherapy for Early Breast Cancer
Depression and anxiety are underrecognized and undermanaged in oncology practice. This article describes the severity of depression and anxiety and associated factors in women with early breast cancer undergoing chemotherapy.
Patient Navigation to Improve Early Access to Supportive Care for Patients with Advanced Cancer in Resource‐Limited Settings: A Randomized Controlled Trial
Patient navigation assists patients in overcoming barriers to care, but its use is under‐used in resource‐limited settings. This article examines whether a patient navigator‐led intervention could improve early access to multidisciplinary supportive and palliative care among Mexican patients with metastatic solid tumors.
Edmonton Symptom Assessment Scale Time Duration of Self‐Completion Versus Assisted Completion in Patients with Advanced Cancer: A Randomized Comparison
The Edmonton Symptom Assessment Scale (ESAS) is a multidimensional assessment tool for self‐reporting of symptom intensity and developed for daily symptom assessment of palliative care patients. This study compared time requirements for self‐completed reports versus reports completed with assistance.
Dermatologic Adverse Events Associated with Selective Fibroblast Growth Factor Receptor Inhibitors: Overview, Prevention, and Management Guidelines
This review provides oncologists with an understanding of dermatologic adverse events related to the use of FGFR inhibitors and proposes guidelines for treatment.
Standardized Supportive Care Documentation Improves Safety of High‐Dose Methotrexate Treatment
Supportive measures are necessary to minimize the risk of side effects from high‐dose methotrexate (HD‐MTX) treatment. This article reports the findings of a study that investigated the implementation of a checklist for control of supportive care and a urine alkalinization protocol to optimize urine alkalinization.
Brief Communications
Prognostic Clinical and Radiographic Biomarkers for BRAF‐Targeted Therapy in Advanced Melanoma
This article explores the need for more accurate clinical biomarkers to predict prognosis in patients with BRAF‐mutated melanoma, reporting a retrospective study of patients with metastatic melanoma treated with BRAF +/– MEK inhibitors.
To Transplant or Not to Transplant During the SARS‐CoV‐2 Pandemic? That Is the Question
The COVID‐19 pandemic has raised many questions in the oncohematological scientific community about risks associated with transplant procedures. This article reports two patient cases, focusing on the risks of performing high‐dose chemotherapy with autologous peripheral blood stem cell transplantation during the COVID‐19 pandemic weighed against the expected clinical benefit.
Dramatic Changes in Oncology Care Pathways During the COVID‐19 Pandemic: The French ONCOCARE‐COV Study
The COVID‐19 pandemic may have affected cancer management. This article evaluates the changes in oncological care pathways during the COVID‐19 crisis, based on results of the ONCOCARE‐COV study.
Cancer in Lockdown: Impact of the COVID‐19 Pandemic on Patients with Cancer
Oncology patients have been severely affected by the ongoing COVID‐19 pandemic that has caused disruption in the traditional health care setting. Although remote health technologies have addressed some of the medical needs, the emotional and mental well‐being of these patients remain underreported. This article reports the primary challenges experienced by cancer patients due to COVID‐19 lockdown measures.
Letters to the Editor
Erdheim‐Chester Disease and Langerhans Cell Histiocytosis: A Case of Overlap Syndrome
Only 500 cases of Erdheim‐Chester disease have been reported in the literature to date. To increase awareness of this rare disease, this letter to the editor describes the unusual case of a woman who was diagnosed with mixed histiocytosis: Erdheim‐Chester disease and Langerhans cell histiocytosis.
Metastatic Mediastinal Germ‐Cell Tumor and Concurrent COVID‐19: When Chemotherapy Is Not Deferrable
This letter to the editor describes the case of a patient with mediastinal germ cell tumor who developed COVID‐19 at the end of the first cycle of chemotherapy and continues the discussion on whether it is best to continue or delay administration of chemotherapy with an active COVID‐19 infection.
In Reply
This letter to the editor responds to the question of whether delayed administration of chemotherapy in patients diagnosed with COVID‐19 is necessary and suggests the importance of evaluating each case carefully before the decision is made.