Journal of Clinical Oncology (JCO) Podcast

This podcast will examine data on utilization, toxicity and survival outcomes with the use of intraperitoneal chemotherapy for initial treatment of ovarian cancer at six NCCN institutions.

Analogous to prior analyses with ABVD, in a large series of Hodgkin lymphoma patients treated with BEACOPP, Haverkamp and colleagues from the German Hodgkin Study Group report that early discontinuation of bleomycin or vincristine due to toxicity has no impact on cure rates or survival.

This podcast explores the complicated relationship between potency, toxicity, and duration of therapy, and how each impacts the overall efficacy of therapy.

This study involved working together across oceans, regulatory bodies in various countries, different cultures in 4 cooperative groups, different standard chemotherapy administration guidelines, and putting aside personal biases and styles to work together and come up with a document acceptable to all, in order to conduct an international trial in a rare disease for the benefit of children with osteosarcoma.

The two recent papers by Kitagawa, et al and Rose, et al, give us treatment options and tools that help maximize not only the benefits of survival with treatment but minimization of non-beneficial treatment toxicity through identification of patients with advanced and recurrent cervical cancer that are most and least likely to benefit.

This podcast places the results of SWOG S0809, a phase II intergroup trial of adjuvant capecitabine/gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma, in context with prior conflicting data and discusses implications for development of a definitive phase III trial.

This is a well-annotated study demonstrating that men treated with androgen deprivation therapy for prostate cancer have impaired cognitive performance within six months of starting therapy and that a specific genetic polymorphism may lend toward greater susceptibility to cognitive impairment.

This is a requested commentary regarding a concurrently-published manuscript which evaluated the utility of omega-2 fatty acids for the treatment of aromatase inhibitor-associated arthralgias.

A meta-analysis of 7 randomized trials comparing EGFR kinase inhibitors to chemotherapy for advanced EGFR-mutant lung cancer has shown that some populations gain greater benefit from targeted therapy – namely never-smokers, woman, and tumor harboring exon 19 deletions.

This podcast discusses a novel immunotherapy approach using an allogeneic whole tumor cell vaccine to prime, and a recombinant antigen-encoded bacterial vector to boost, immune responses against pancreatic cancer and explains why this approach may be beneficial in the treatment of advanced pancreatic cancer.

In summary, healthcare providers caring for breast cancer patients hopefully recognize the need for consideration of genetic testing in appropriate individuals, and communicate that need to the patient. A discussion about why genetic testing is not appropriate may be as beneficial as one about why it is, and oncology providers should consider briefly discussing genetics with all patients, even if the subject is provider-initiated.

Review and comments on BFM experience of ALL hematopoietic transplantation.

This podcasts provides perspective on a recent report evaluating disease volume and surgical complexity on post-operative tumor residuum and survival in ovarian cancer patients.

In this podcast, Dr. Claire Snyder discusses how patient-reported outcomes provide a critical perspective to evaluating health conditions and their treatment, and describes several tools available to facilitate the measurement and application of PROs.

An analysis of the PROFILE studies and opportunities for treatment of ALK-rearranged non-small cell lung cancer

The development and practical utility of a model developed in the Mayo benign breast disease cohort to predict invasive breast cancer risk after benign breast disease is described.

This JCO Podcast provides observations and commentary on the JCO article, "Large retroperitoneal lymphadenopathy as a predictor of venous thromboembolism in patients with disseminated germ cell tumors treated with chemotherapy" by Amirrtha Srikanthan, et al.

This is an oral commentary on patients with endometrial or rectal cancer, and their risk of developing second malignancies with or without radiation.

In a randomized RTOG study of chemotherapy concurrent with accelerated vs standard fractionated radiotherapy for head and neck cancer, it was found that patients treated in institutions who accrued a large number of patients had better outcomes compared with those treated at low-volume institutions, highlighting the importance of referring patients with advanced cancer to high-volume centers.

This podcast reviews the available data from clinical trials using cyclooxygenase-2 inhibition with chemotherapy in non-small cell lung cancer and provides a perspective on patient selection and future directions.

This four-arm randomized controlled trial of cognitive behavioral therapy for insomnia in cancer patients confirmed its effectiveness but did not demonstrate benefit from the addition of a daytime wakefulness-promoting agent.

This podcast is a review of the submitted article by Dr. Wentzensen and colleagues regarding multiple cervical biopsies at the time of colposcopy and the implications for the management of cervical dysplasia.

A secondary analysis of a multicenter randomized trial suggests that the R-ACVBP regimen may improve outcomes in younger patients with the non-germinal center B-cell subtype of diffuse large B-cell lymphoma.

Modifying therapy based upon positive DTCs in breast cancer.

NCIC SC.20 demonstrates that a second course of radiation for painful osseous metastases significantly improves patients quality of life and function.

Long-term follow up from the landmark, NCI-sponsored adjuvant trastuzumab trials confirms the clinical benefits and clinical safety of this important therapy.

This podcast provides a commentary on the association of braf mutation and thyroid cancer showing an increase risk of recurrence in patients with thyroid cancer that harbor this mutation.

In this podcast, the results of the S0008 adjuvant intergroup trial are discussed and placed in the context of current advances in melanoma treatment.

This is a prospective study of proton radiotherapy for rhabdomyosarcoma showing equivalent efficacy with photon treatment.

Tailoring treatment in intermediate-risk pediatric Hodgkin lymphoma is feasible using an early response-based assessment for the omission of radiotherapy.

Given the high rate of unplanned hospitalizations in older cancer patients, multidisciplinary care is needed for outcomes improvement.

Minimal residual disease monitoring has been very helpful in early response evaluation and risk stratification of children with acute lymphoblastic leukemia (ALL). This podcast discusses the pros and cons of extended MRD monitoring throughout the duration of therapy for childhood ALL.

This podcast describes the report of a cohort of Chinese patients with known prior hepatitis B exposure, receiving rituximab as part of their therapy for lymphoma. The podcast includes a summary of the trial and discussion of the finding that while reactivation of hepatitis B is common in this population, if treatment with antivirals is started soon after the detection of a positive viral load, then pathology related to hepatitis B can be avoided.

In this paper, the authors demonstrate that only a very small percentage of patients from 2 large, prospective cohorts developed recurrent diffuse large B-cell lymphoma detected solely on post remission imaging. In addition, the overall survival of these patients was not different from that of patients who presented with symptoms or findings on physical exam. I will review the data and discuss its possible implications for the clinical care of patients in remission at the completion of front-line chemotherapy.

A phase I/II study of the antibody-drug conjugate glembatumumab vedotin (CDX-011 or CR011-vcMMAE) in patients with locally advanced or metastatic breast cancer, reveals an acceptable safety profile and promising clinical activity in GPNMB expressing breast cancer.

Conventional GVHD prophylaxis with calcineurin inhibitors has a high incidence of chronic GVHD. Kanakri et al show that post-transplant administration of High dose cyclophosphamide is an effective way of reducing chronic GVHD. Limitations of this approach and alternative approaches are briefly discussed.

Many new oncology drugs are expensive. Drug prices may not reflect the whole cost of new agents, as increases or decreases in adverse effects compared to previously available therapies may influence cost comparisons. This podcast summarizes a meta-analysis of the economic consequences of adverse effects in 41 registration trials that led to approval of new oncology drugs between 2000 and 2011.

This podcast discusses a phase 2 trial of cabozantinib in men with advanced bone-metastatic prostate cancer, using a novel method to assess bone scan response.

This podcast discusses the results and practical implications of a population-based study that found an increased fracture risk after cystectomy for bladder cancer.

This podcast discusses the current state of knowledge regarding allogeneic transplantation as a treatment modality for advanced systemic mastocytosis.

This study assessed diabetes mellitus risk in long-term Hodgkin lymphoma survivors, and found that a mean pancreatic tail dose of 36 Gy or higher was associated with a significantly increased risk of diabetes mellitus. This finding has important implications in the follow up of long-term Hodgkin lymphoma survivors, and also suggests that in newly diagnosed patients with upper abdominal involvement, the pancreas should be included as in organ-in-risk in the radiotherapy planning.

This podcast reviews the publication of the RESORT manuscript, and puts these results into context with the recently published Ardeshna trial of rituximab vs. observation in follicular lymphoma, concluding that there is no longer a role for rituximab maintenance in low tumor burden follicular lymphoma.

This podcast will use the study reported by Bejar and colleagues to review the role of screening for TET2, DNMT3A, and particularly TP53, mutations in deciding whether to recommend allogeneic hematopoietic cell transplant for patients with myelodysplastic syndromes.

This JCO Podcast provides observations and commentary on the JCO article, "Oncology Fellows' Career Plans, Expectations and Well-Being: Do Oncology Fellows Know What They are Getting In To?" by Tait D. Shanafelt, et al.

This study reports surprisingly good outcomes for children with Ph-like ALL treated on the St. Jude Total Fifteen clinical trial.

Corticosteroids are recommended as part of the WHO analgesic ladder but there is limited evidence for their efficacy for the treatment of pain in cancer patients.

The availability of reconstructive surgeons restricts the use of immediate breast reconstruction, creating unintended inequities even in a system with universal health care coverage.

This podcast describes the rising epidemic of HPV-associated oropharynx cancer, its unique demographic profile and natural history, and comments on new findings from Carole Fakhry et al. regarding patterns of disease recurrence seen in patients enrolled on RTOG 0129 and 0522.

This podcast discusses the report of cardiac monitoring data from the HERA trial, places the findings in context with data from other trials, and considers how the report relates to clinical practice.

This is a review of breast needle biopsy for the diagnosis of breast cancer and how surgeons and geography affect utilization and the resultant impact on quality of care.