Clinical cancer advances 2018: Annual report on progress against cancer from the American Society of Clinical Oncology

TY - JOUR

T1 - Clinical cancer advances 2018

T2 - Annual report on progress against cancer from the American Society of Clinical Oncology

AU - Heymach, John

AU - Krilov, Lada

AU - Alberg, Anthony

AU - Baxter, Nancy

AU - Chang, Susan Marina

AU - Corcoran, Ryan

AU - Dale, William

AU - DeMichele, Angela

AU - Magid Diefenbach, Catherine S.

AU - Dreicer, Robert

AU - Epstein, Andrew S.

AU - Gillison, Maura L.

AU - Graham, David L.

AU - Jones, Joshua

AU - Ko, Andrew H.

AU - Lopez, Ana Maria

AU - Maki, Robert G.

AU - Rodriguez-Galindo, Carlos

AU - Schilsky, Richard L.

AU - Sznol, Mario

AU - Westin, Shannon Neville

AU - Burstein, Harold

N1 - Funding Information: This advance would not be possible without robust federal investment in cancer research. The first clinical trial of CAR T-cell therapy in children with ALL was funded, in part, by grants from the National Cancer Institute (NCI), and researchers at the NCI Center for Cancer Research were the first to report on possible CAR T-cell therapy for multiple myeloma. These discoveries follow decades of prior research on immunology and cancer biology, much of which was supported by federal dollars. Funding Information: Research funded by the NIH also fuels the innovation on which companies depend to bring new treatments to the marketplace, helping make the United States the global leader in developing treatments. Studies show that NIH investments in biomedical research stimulate increased private investment: Every dollar of increase in public clinical research stimulates 2.35 dollars of industry investment at 3 years.7 Funding Information: Founded in 1964, ASCO is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents . 40,000 oncology professionals who care for patients living with cancer. Through research, education, and the promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world in which cancer is prevented or cured and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www. ASCO.org; explore patient education resources at www.Cancer.Net; and follow us on Facebook, Twitter, LinkedIn, and YouTube. Funding Information: This report was supported, in part, by funds from Conquer Cancer’s Mission Endowment. Funding Information: Another study found that, among US teenagers 12 to 17 years of age, the rate of e-cigarette use is already approaching the rate of tobacco cigarette use; 3.1% smoked e-cigarettes compared with 4.6% who smoked tobacco cigarettes in the last 30 days (this study was funded, in part, by grants from the National Institute on Drug Abuse, NIH, and the FDA).22 However, among adults, e-cigarette use still lags far behind tobacco cigarette use (6.7% v 22.5%). In addition, among those who used more than one tobacco product, 15% of teenagers and 23% of adults used both e-cigarettes and traditional cigarettes. Funding Information: FDA approval was based on findings from 149 patients with MMR-deficient or MSI-H solid tumors—90 had colorectal cancer and 59 had one of 14 other types of cancer—who were enrolled in five clinical trials. Tumors shrank in 40% of patients, and in 78% of those patients, tumor response lasted $ 6 months. In one of the studies that included patients with 12 different types of cancer, 21% of patients experienced a complete remission of cancer (this study was funded, in part, by grants from the NIH).27 Funding Information: This new approval was based on a clinical trial in which women received standard chemotherapy alone or bevacizumab with standard paclitaxel plus carboplatin chemotherapy, followed by maintenance therapy with bevacizumab (this study was funded, in part, by a grant from the NCI).67 Addition of bevacizumab significantly extended median time until cancer worsening to 13.8 months compared with 10.4 months with chemotherapy alone. Overall survival was also longer with bevacizumab than with chemotherapy alone (median, 42 months v 37 months), but this difference was not statistically significant; however, the rate of severe adverse effects was higher in the bevacizumab group (96%) than in the standard therapy group (86%), with high blood pressure and fatigue being the most common adverse effects with bevacizumab. Funding Information: A recent large clinical trial found that adding androgen-deprivation therapy to radiation therapy helps men, who experience a local recurrence after surgery, live longer (this study was funded, in part, by a grant from the NCI).72 The study enrolled men with prostate-specific antigen levels between 0.2 ng/mL and 4 ng/mL at least 8 weeks after surgery. Men were randomly assigned to receive androgen-deprivation therapy bicalutamide during and 24 months after radiation therapy or radiation therapy and placebo. Survival rate at 12 years was 76% in the bicalutamide group versus 71% in the placebo group. More men in the placebo group developed metastatic prostate cancer (23% v 14%, respectively) and more died of the disease (13% v 6%, respectively). Late effects of radiotherapy were similar between groups, but gynecomastia (swelling of breast tissue) was much more common with bicalutamide, occurring in 70% of men compared with 11% of those who received placebo. Funding Information: Another clinical trial that compared surgery with active surveillance found that men who received surgery had more sexual dysfunction and urinary incontinence through 10 years than did those who received active surveillance (this study was funded, in part, by grants from the US Department of Veterans Affairs, the Agency for Healthcare Quality and Research, and the NCI).77 Limitations in activities of daily living through 2 years were also greater in the surgery group. Funding Information: Six clinical trials with 12,800 patients in North America, Europe, and Japan explored whether adjuvant chemotherapy regimens that consisted of either FOLFOX (infusional fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin) could be shortened to 3 months without compromising survival. In 2017, researchers reported on the analysis of pooled data from the trials (this study was funded, in part, by a grant from the NCI).80 Funding Information: A recent large, population-based study assessed the effect of this recommendation on the rates of breast cancer surgery (this study was funded, in part, by a grant from the NCI).83 From 2013 to 2015, the rate of initial lumpectomy remained stable at 67%, but the rate of second breast surgery declined by 16%, and fewer women underwent a subsequent mastectomy. This study demonstrates the important role of clinical practice guidelines in reducing overtreatment. Funding Information: Two separate clinical trials found that lowering the standard radiation dose by 15% to 20% in patients with a favorable prognosis (ie, a complete clinical response is achieved with initial chemotherapy) does not compromise survival. In the first study, the 2-year survival rate was 94% for patients who were treated with 54 Gy and 96% for those who received # 54 Gy, and adverse effects were milder with the lower dose (this study was supported, in part, by grants from the NCI and the US Department of Health and Human Services).85 At 12 months, markedly fewer patients in the lower-dose group had difficulty swallowing solids (40% v 89%, respectively) or impaired nutrition (10% v 44%, respectively) compared with patients who received higher doses of treatment. In the second study, where patients with a more favorable prognosis received a dose of 54 Gy and others received 60 Gy, cancer had not worsened for 92% of patients overall at 2 years.86 Funding Information: In one study, a communication coaching intervention helped patients with late-stage cancer actively seek information and express preferences about their care (this study was funded, in part, by a grant from the NCI).87 Oncologists in the intervention group received brief, individualized, skill-based communication training that focused on being receptive to patient questions and concerns. Patients received individualized communication coaching that incorporated a list of questions related to cancer care and end-of-life issues. Oncologists and patients in the control group did not receive any communication training or prompting. Funding Information: New online tools are another way of helping patients plan for the end of life. In a recent study of elderly patients with chronic and/or serious conditions, 35% of those who used the interactive, patient-centered advance care planning Web site, PREPARE, along with an easy-to-read advance directive, succeeded in assembling advance planning documentation compared with 25% of those who used the advance directive alone (this study was funded by a grant from the US Department of Veterans Affairs Office of Research and Development).88 Given that the Web site used in this study is free to the public and requires no physician involvement, it represents a method of improving end-of-life care with minimal health care system resource expenditure. Funding Information: Research shows that certain coping strategies can help patients with incurable cancer who accurately understand their diagnosis to be terminal (this study was funded, in part, by grants from the NIH, NCI, and the National Institute of Nursing Research).89 For example, patients who used positive reframing (ie, looking for something good in their situation) and active coping (ie, taking action to try to make their situation better) had improved quality of life and less depression. Funding Information: In an analysis of patients who were treated in six clinical trials from 1996 to 2009, 21% of those who received a high dose of radiation ($ 20 Gy) developed symptomatic heart problems within 2 years (this study was funded by a grant from the NIH).91 Heart problems were independently linked to high doses of radiation and underlying risk (eg, smoking and cardiovascular disease). Funding Information: treatments, which are exercise, psychological intervention, combined exercise and psychological intervention, and medication (this study was funded in part by grants from the NIH).95 Funding Information: Whereas many countries have experienced decreases in cancer mortality over the last decade, cancer deaths increased in Sub-Saharan Africa and certain other regions lacking in health care infrastructure (this study was funded in part by a grant from the NIH).103 Seven of 10 cancer deaths occur in regions of Africa, Asia, and Central and South America, where access to cancer screening and treatment is limited.104

PY - 2018/4/1

Y1 - 2018/4/1

UR - http://www.scopus.com/inward/record.url?scp=85045017824&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045017824&partnerID=8YFLogxK

U2 - 10.1200/JCO.2017.77.0446

DO - 10.1200/JCO.2017.77.0446

M3 - Article

C2 - 29380678

AN - SCOPUS:85045017824

SN - 0732-183X

VL - 36

SP - 1020

EP - 1044

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 10

ER -