Oncology Practice and COVID-19: Addressing the Challenges With Mark A. Lewis, MD

The COVID-19 pandemic has created multiple challenges to cancer care, ranging from the risk of exposure to novel coronavirus involved in having patients come to the hospital or clinic for treatment to the risks that immunosuppressive cancer treatments––and cancer itself––may pose in making patients more susceptible to COVID-19. How should these risks be balanced against the necessity of life-preserving cancer therapies? Mark A. Lewis, MD, Director of Gastrointestinal Oncology at Intermountain He...
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Encorafenib/Cetuximab for BRAF V600E–Mutant Metastatic Colorectal Cancer: Scott Kopetz, MD, PhD, FACP

After patients with metastatic colorectal cancer who have a BRAF V600E mutation stop responding to first-line treatment, they have a median survival of only four to six months. These patients now have a new option in a combination therapy consisting of encorafenib (Braftovi®, Array BioPharma) and cetuximab (Erbitux®, Lilly), which was approved by the FDA earlier this month for adults with previously treated BRAF V600E-mutated metastatic colorectal cancer. In this interview with i3 Health, Scott ...
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Mitomycin Gel for Low-Grade Upper Tract Urothelial Cancer: Seth P. Lerner, MD, FACS

Upper-tract urothelial cancer (UTUC) is a rare cancer that often needs to be treated with radical surgery, typically entailing complete removal of the affected kidney, ureter, and bladder cuff. Mitomycin C formulated with a reverse thermal hydrogel (JelmytoTM, UroGen Pharma), recently approved by the FDA as the first agent specifically indicated for the treatment of low-grade UTUC, will now allow some patients to keep a kidney that would otherwise have needed to be removed. In this interview wit...
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Pemigatinib for Cholangiocarcinoma: An Interview With Ghassan Abou-Alfa, MD, MBA

Fibroblast growth factor receptor (FGFR) 2 gene alterations can occur in the pathogenesis of cholangiocarcinoma. Pemigatinib (PemazyreTM, Incyte Corporation), a newly FDA approved oral inhibitor of FGFR2, has shown efficacy in patients with previously treated, locally advanced, or metastatic cholangiocarcinoma with and without FGFR2 gene alterations. Approval was granted based a study led by Ghassan Abou-Alfa, MD, MBA from Memorial Sloan Kettering Cancer Center. In an interview with i3 Health, D...
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Durvalumab for Extensive-Stage Small-Cell Lung Cancer: Jonathan Goldman, MD

In this interview, Jonathan Goldman, MD, speaks with i3 Health about the recent FDA approval of durvalumab (Imfinzi®, AstraZeneca) in combination with platinum/etoposide for patients with extensive-stage small-cell lung cancer (ES-SCLC). The approval was based on CASPIAN, a phase 3 trial in which durvalumab/platinum/etoposide significantly increased median overall survival and produced a higher overall response rate compared with platinum/etoposide alone. Dr. Goldman, Associate Professor of Hema...
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PSMA PET-CT For Staging High-Risk Prostate Cancer: An Interview With Michael Hofman, MBBS

Results from a multicenter, randomized study (ANZCTR12617000005358) have shown that prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) has superior efficacy in staging men with high-risk localized prostate cancer compared with conventional imaging using computed tomography (CT) and bone scan. In an interview with i3 Health, lead investigator from the study, Michael Hofman, MBBS, discusses challenges of treating patients with high-risk prostate can...
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Managing Breast Cancer Treatment During COVID-19: Jill Dietz, MD, FACS

How should cancer care providers balance the needs of treatment against the risk of COVID-19? A group of representatives from multiple cancer care organizations with expertise in the multidisciplinary management of breast cancer has sought to answer this question through their set of recommendations for prioritizing, treating, and triaging patients with breast cancer during the pandemic. In this interview with i3 Health, Jill R. Dietz, MD, FACS, President of the American Society of Breast Surgeo...
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Digital Breast Tomosynthesis for Breast Cancer Screening: Diana Miglioretti, PhD

In women undergoing screening for breast cancer, high recall rates—the proportion of patients who need to have their screening examination repeated due to a false-positive initial assessment—are often associated with increased costs and heightened patient anxiety. While the American College of Radiology recommends an upper threshold of 12% for recall rate, only 62.2% of radiologists meet this recommendation. In a recent study, Diana Miglioretti, PhD, Division Chief of Biostatistics at the U...
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Closing the Gender Gap in Oncology Academic Leadership: Reshma Jagsi, MD, DPhil

​A recent study by Mudit Chowdhary, MD, and colleagues revealed that a substantial gender gap remains in academic oncology leadership: in a web query of 265 of the 273 accredited medical, radiation, and surgical oncology training programs, only 35.9% of faculty members were women. Representation was substantially lower among department chairs, with 21.7% of medical oncology programs, 11.7% of radiation oncology programs, and a mere 3.8% of surgical oncology programs chaired by women. In this int...
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E-Cigarettes and Bladder Cancer Risk: Marc Bjurlin, DO, MSc

Despite their known pulmonary, neurological, and carcinogenic risks, electronic cigarette (e-cigarette) use has increased drastically in recent years, especially among adolescents and young adults. In a recent study, a team of researchers led by Marc Bjurlin, DO, MSc, Associate Professor of Urology at the University of North Carolina Chapel Hill's Lineberger Comprehensive Cancer Center, analyzed the urine samples of e-cigarette users and identified the presence of several carcinogenic biomarkers...
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COVID-19 Risk in Cancer Patients: Melvin LK Chua, MBBS, FRCR, PhD, and Conghua Xie, MD, PhD

Last week, a research team under the direction of Conghua Xie, MD, PhD, and Melvin LK Chua, MBBS, FRCR, PhD, reported in JAMA Oncology that patients with cancer at a hospital in Wuhan, China, experienced an increased risk of COVID-19 infection relative to other members of the community. In this interview with i3 Health, Dr. Chua and Dr. Xie discuss their findings and analyze possible factors contributing to the increased risk of COVID-19 infection in patients with cancer. Can you comment on the ...
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Head and Neck Cancer: Reducing In-Hospital Mortality With Eric Adjei Boakye, PhD

​Over 4% of head and neck cancer (HNC) patients who are hospitalized die during their stay in the hospital. How can this number be reduced? In a cross-sectional study recently published in JAMA Otolaryngology—Head and Neck Surgery, a research team led by Eric Adjei Boakye, PhD, found that among a variety of other patient- and hospital-related factors, male sex, weekend admissions, and treatment at nonteaching hospitals are associated with increased in-hospital mortality. In this interview with i...
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Expanding Later-Line Treatment Options for Multiple Myeloma: Paul G. Richardson, MD

Earlier this month, ​the FDA approved isatuximab-irfc (Sarclisa​®​, Sanofi), an anti-CD38 monoclonal antibody, in combination with pomalidomide and dexamethasone for adults with multiple myeloma who have received at least two prior lines of treatment, including lenalidomide and a proteasome inhibitor. In this interview with i3 Health, Paul G. Richardson, MD, who served as the co-primary investigator of the ICARIA-MM study, on which the isatuximab approval was based, shares his thoughts on the si...
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Metastatic Colorectal Cancer: Treatment Challenges, Progress, and Advice With Chiara Cremolini, MD

Colorectal cancer is the third leading cause of cancer death and the fourth most common diagnosed cancer in the world. Often, this disease is left undiagnosed until it reaches an advanced stage. Unfortunately, late-stage metastatic colorectal cancer has a poor prognosis with a 5-year survival rate of only 12%. In an interview with i3 Health, Chiara Cremolini, MD, provides insights on the challenges of treating patients with metastatic colorectal cancer, explains how metastatic colorectal cancer ...
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FOLFOXIRI Efficacy in Metastatic Colorectal Cancer: Chiara Cremolini, MD

Results of TRIBE2, a phase 3 trial (NCT02339116), show that the triplet treatment FOLFOXIRI (fluorouracil/leucovorin/oxaliplatin/irinotecan) plus bevacizumab is more effective at treating patients with metastatic colorectal cancer than FOLFIRI (irinotecan/leucovorin/fluorouracil) plus bevacizumab. In an interview with i3 Health, Chiara Cremolini, MD, lead researcher of this study, provides insights on the results of this trial as well as how the future of treatment for metastatic colorectal canc...
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Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma: Alison Birtle, MD

Upper tract urothelial carcinoma (UTUC) is a rare malignancy with a mortality rate of over 50% for locally advanced disease. However, few clinical trials have been conducted due to its low incidence rate. Nephroureterectomy—a surgical procedure in which the renal pelvis, kidney, ureter, and bladder cuff are removed—is considered the standard treatment approach for patients with UTUC, but little research had been conducted regarding the optimal treatment after surgery. In the phase 3 PO...
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Milk and Breast Cancer Risk: Gary E. Fraser, MBChB, PhD

​United States Dietary Guidelines recommend that adults and children aged 9 or older consume three cups per day of low-fat or fat-free milk and dairy foods, or alternatively, three cups of calcium-fortified soymilk. However, a large observational study recently published in the International Journal of Epidemiology reports that consuming three cups of dairy milk per day is associated with a risk of breast cancer that is increased by as much as 80%, regardless of the fat content of the milk,...
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Neratinib: Progress for HER2-Positive Metastatic Breast Cancer With Adam Brufsky, MD, PhD, FACP

Last week, the FDA added a second approval for neratinib (Nerlynx​®​, Puma Biotechnology, Inc.) in combination with capecitabine for adults with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer previously treated with at least two anti-HER2–based regimens in the metastatic setting. This adds to the previous approval of neratinib, an irreversible pan-HER tyrosine kinase inhibitor, for the extended adjuvant treatment of early-stage HER2-positive breast cancer followi...
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Nadofaragene Firadenovec in Non–Muscle-Invasive Bladder Cancer: Colin Dinney, MD

​High-grade non–muscle-invasive bladder cancer that does not respond to intravesical Bacillus Calmette-Guerin (BCG) therapy carries a substantial risk of disease recurrence and progression, and effective salvage intravesical therapies are sorely needed for patients who are unable or unwilling to undergo cystectomy. According to results of a multicenter, open-label phase 3 trial presented in February at the American Society of Clinical Oncology (ASCO) 2020 Genitourinary Cancers Symposium, intrave...
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RNF43 Variation and Cetuximab Efficacy in Metastatic Colorectal Cancer: Francesca Battaglin, MD

​In metastatic colorectal cancer, there has been a concerted effort to identify biomarkers that can predict the efficacy of existing treatments and support the development of new targeted therapies. As part of these efforts, Francesca Battaglin, MD, and colleagues investigated the association between cetuximab efficacy and gene expression levels and genetic variants in the R-Spondin/RNF43 complex. For their analysis, the researchers used genomic DNA from blood samples of participants in the phas...
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