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The Oncologist: Volume 26, Issue 11
899-924, e1898-e1908, 925-e1930, 927-933, e1931-e1961, 934-940, e1962-e1981, 941-955, e1982-e1991, 956-964, e1992-e2020, 965-982, e2021-e2052, 983-987, e2053-e2096, 988-989, e2097-e2098November 2021
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Commentaries
Revisiting EXTREME in the Immuno-Oncology Era: How to Improve Its Outcomes
- Pages: 899-901
- First Published: 10 September 2021
The choice of first-line palliative treatment has always been one of the crucial decisions in the management of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck not suitable for salvage surgery or full-dose radiotherapy. This commentary highlights trial results that show the importance of treatment sequencing decisions that should be of interest for daily practice.
Informed Consent 2021: The “Terms and Conditions” of the Research World
- Pages: 902-903
- First Published: 27 June 2021
Most clinicians who participate in clinical research are viscerally aware that the current informed consent process is failing patients. Improving our informed consent process is important to the quality of clinical care and to the integrity of clinical trials.
Nature versus Nurture: Investigating Racial Disparity in Advanced Prostate Cancer
- Pages: 904-905
- First Published: 01 August 2021
Considering recently published studies, this commentary addresses racial inequality in cancer care for patients with prostate cancer.
Minimally Deviated Lymphohematopoietic Neoplasms: Nomenclature in the Context of Pathobiology
- Pages: 906-909
- First Published: 18 August 2021
This commentary highlights the classification of disease, in particular the terminology for classifying lymphoid and myeloid neoplasms.
Racism and Cancer Care
Adherence to Endocrine Therapy and Racial Outcome Disparities in Breast Cancer
- Pages: 910-915
- First Published: 28 September 2021
The disparity in outcomes of breast cancer for Black compared to White women in the United States is well-known. This article examines the factors contributing to these persistent disparities, including biological and access-related determinants.
Precision Medicine Clinic: Molecular Tumor Board
Rapid Progression of Metastatic Pancreatic Adenocarcinoma During Platinum-Based Therapy in a Patient Harboring a Pathogenic BRCA2 Germline Variant
- Pages: 916-918
- First Published: 26 July 2021
Most patients with pancreatic adenocarcinoma who carry a germline pathogenic BRCA variant respond well to platinum-based therapy or PARP inhibitor therapies. The case presented here suggests that more studies are needed to determine whether sporadic cancers are less responsive to such therapies than BRCA-related cancers.
Mosaicism for Receptor Tyrosine Kinase Activation in a Glioblastoma Involving Both PDGFRA Amplification and NTRK2 Fusion
- Pages: 919-924
- First Published: 26 May 2021
This article reports a case of a 26-year-old man with an IDH-wild type glioblastoma mosaic for both NTRK2 fusion and receptor tyrosine kinase amplification. He showed a robust but temporary response to the recently-approved NTRK inhibitor larotrectinib with subsequent outgrowth of a PDGFRA-amplified subclone.
Gefitinib Combined with Cetuximab for the Treatment of Lung Adenocarcinoma Harboring the EGFR–Intergenic Region (SEC61G) Fusion and EGFR Amplification
- Pages: e1898-e1902
- First Published: 03 August 2021
EGFR fusions are rare genomic events in non-small cell lung cancer. This brief report provides evidence that combined targeted therapy with gefitinib and cetuximab could result in a significant antitumor response in patients with the EGFR-IGR fusion and EGFR amplification.
Successful Treatment of Afatinib Reversing Epidermal Growth Factor Receptor Exon19Deletion/G724S Mutation Resistance Guided by Protein-Drug Docking
- Pages: e1903-e1908
- First Published: 15 August 2021
This brief communication presents the case of a patient with acquired Ex19Del/G724S mutation who was treated with afatinib and obtained long-term clinical benefit.
Clinical Trial Results
First-In-Human, First-In-Class, Phase I Trial of the Fucosylation Inhibitor SGN-2FF in Patients with Advanced Solid Tumors
- Pages: 925-e1918
- First Published: 20 July 2021
Adoptive Transfer of Autologous Invariant Natural Killer T Cells as Immunotherapy for Advanced Hepatocellular Carcinoma: A Phase I Clinical Trial
- Pages: e1919-e1930
- First Published: 13 July 2021
Breast Cancer
Prospective Study Testing a Simplified Paclitaxel Premedication Regimen in Patients with Early Breast Cancer
- Pages: 927-933
- First Published: 02 September 2021
To avoid hypersensitivity reactions, corticosteroids are routinely prescribed before each dose of paclitaxel. This article reports the results of a study that focused on whether corticosteroids could be safely omitted in later cycles of treatment if reactions did not occur during earlier cycles.
Increased Risk for Ipsilateral Breast Tumor Recurrence in Invasive Lobular Carcinoma after Accelerated Partial Breast Irradiation Brachytherapy
- Pages: e1931-e1938
- First Published: 13 September 2021
In this retrospective review of 946 patients, the authors investigate the effectiveness of accelerated partial breast irradiation for select patients with invasive breast cancer and determined that patients deemed unsuitable for this treatment by criteria established by the American Brachytherapy Society or the American Society for Radiation Oncology were not at increased risk for ipsilateral breast tumor recurrence
Hormone Receptor Subtype in Ductal Carcinoma in Situ: Prognostic and Predictive Roles of the Progesterone Receptor
- Pages: e1939-e1950
- First Published: 17 August 2021
This study investigated the prognostic and predictive roles of the hormone receptor subtype in patients with newly diagnosed ductal carcinoma in situ, focusing on the prognostic and predictive values of progesterone receptor status independent of estrogen receptor status. The prognostic effect of tamoxifen therapy was also investigated
Treatment Patterns and Outcomes of Women with Symptomatic and Asymptomatic Breast Cancer Brain Metastases: A Single-Center Retrospective Study
- Pages: e1951-e1961
- First Published: 10 September 2021
Despite advances in treatment, the prognosis of patients with breast cancer brain metastasis remains poor. This article assesses treatment patterns and outcomes of such patients in the modern era of stereotactic radiosurgery.
Cancer Diagnostics and Molecular Pathology
Physician Communication and Patient Understanding of Molecular Testing Terminology
- Pages: 934-940
- First Published: 09 August 2021
In the past decade, identifying genomic markers and corresponding targets through molecular testing has become increasingly important in the field of oncology, as it allows for a more personalized approach to cancer treatment. This article focuses on how oncologists describe molecular testing and whether patients understand the terminology being used.
Framework for Implementing and Tracking a Molecular Tumor Board at a National Cancer Institute–Designated Comprehensive Cancer Center
- Pages: e1962-e1970
- First Published: 14 August 2021
This article describes the initiation and implementation of two molecular tumor boards (MTBs) at Vanderbilt-Ingram Cancer Center: an institutional board for patients and a global community MTB open to the larger oncology patient population. This reproducible framework may be adopted by other institutions to recreate MTBs.
Validation of a Circulating Tumor DNA-Based Next-Generation Sequencing Assay in a Cohort of Patients with Solid tumors: A Proposed Solution for Decentralized Plasma Testing
- Pages: e1971-e1981
- First Published: 19 July 2021
This report describes the concordance between circulating tumor DNA and matched tumor tissue molecular profiles, discusses interpretation of observed discordant data, and illustrates applications through clinical cases. It is the first known report to evaluate the performance of an on-site plasma-based next-generation sequencing test to detect microsatellite instability status along with common sequence alterations in the context of its clinical utility and therapeutic applications in precision oncology.
Gastrointestinal Cancer
Sunitinib and Evofosfamide (TH-302) in Systemic Treatment-Naïve Patients with Grade 1/2 Metastatic Pancreatic Neuroendocrine Tumors: The GETNE-1408 Trial
- Pages: 941-949
- First Published: 30 June 2021
The SUNEVO trial pursued the hypothesis that the hypoxia induced by sunitinib might foster the activation of the prodrug evofosfamide in patients with locally advanced or metastatic pancreatic neuroendocrine tumors. Results are reported here.
Temozolomide in Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms: A Multicenter Retrospective Review
- Pages: 950-955
- First Published: 03 August 2021
There has been increasing interest in the combination of capecitabine and temozolomide (CAPTEM) for the treatment of gastroenteropancreatic neuroendocrine neoplasm (GEPNEN). This review reports a large retrospective analysis to report the efficacy and tolerability of temozolomide (TEM)-containing regimens, particularly CAPTEM, in patients with grade 3 GEPNENs.
Implementation of an Embedded In-Clinic Genetic Testing Station to Optimize Germline Testing for Patients with Pancreatic Adenocarcinoma
- Pages: e1982-e1991
- First Published: 10 September 2021
Germline genetic testing is universally recommended for patients with pancreatic cancer, but testing remains infrequent. This article reports a patient intake workflow that was implemented to expedite genetic counseling and facilitate sample collection. The authors describe the impact of this innovation on rates of genetic counseling and testing.
Genitourinary Cancer
Clinical Outcomes and Racial Disparities in Metastatic Hormone-Sensitive Prostate Cancer in the Era of Novel Treatment Options
- Pages: 956-964
- First Published: 07 June 2021
This article presents a retrospective review of 168 patients diagnosed with metastatic hormone-sensitive prostate cancer who received upfront therapy with either docetaxel (DOC) or abiraterone (ABI), focusing on real-world clinical outcomes and potential racial disparities.
Geriatric Oncology
Association Between Caregiver-Oncologist Discordance in Patient's Life Expectancy Estimates and Caregiver Perceived Autonomy Support by the Oncologist
- Pages: e1992-e2001
- First Published: 26 July 2021
Prognostic discordance refers to a discrepancy in estimates of prognosis by two individuals. This article evaluates the association between caregiver-oncologist prognostic discordance regarding a patient's life expectancy estimates and caregiver perceived autonomy support.
Health Outcomes and Economics of Cancer Care
Real-World Clinical and Economic Outcomes in Selected Immune-Related Adverse Events Among Patients with Cancer Receiving Immune Checkpoint Inhibitors
- Pages: e2002-e2012
- First Published: 30 July 2021
This large real-world evidence study assessed the prevalence of immune-related adverse events among patients who received immune checkpoint inhibitors and associated clinical and economic outcomes
First-Line Durvalumab in Addition to Etoposide and Platinum for Extensive-Stage Small Cell Lung Cancer: A U.S.-Based Cost-Effectiveness Analysis
- Pages: e2013-e2020
- First Published: 25 August 2021
The cost-effectiveness of durvalumab has been in the spotlight by reason of its high acquisition cost. This study evaluates the cost-effectiveness of durvalumab plus etoposide and platinum in the first-line setting for treatment-naïve extensive-stage small cell lung cancer from the perspective of the U.S. payer.
Hematologic Malignancies
Clinical Outcomes, Treatment Toxicity, and Health Care Utilization in Older Adults with Aggressive Non-Hodgkin Lymphoma
- Pages: 965-973
- First Published: 29 July 2021
Balancing treatment efficacy with risk of complications is critical for older adults with aggressive non-Hodgkin lymphoma. This article describes the clinical outcomes, treatment toxicity, and health care utilization of older adults treated for aggressive non-Hodgkin lymphoma and identifies factors associated with augmented treatment toxicity and health care utilization.
Tyrosine Kinase Inhibitors and Vascular Adverse Events in Patients with Chronic Myeloid Leukemia: A Population-Based, Propensity Score-Matched Cohort Study
- Pages: 974-982
- First Published: 21 August 2021
Concerns have been raised regarding long-term adverse events related to tyrosine kinase inhibitor (TKI) treatment. This article reports on the incidence of TKI-associated vascular adverse events in a cohort of Taiwanese patients with chronic myeloid leukemia.
Neurocognitive Impairment After Hematopoietic Stem Cell Transplant for Hematologic Malignancies: Phenotype and Mechanisms
- Pages: e2021-e2033
- First Published: 22 June 2021
This review summarizes the current literature surrounding the nature of cognitive dysfunction after hematopoietic stem cell transplant (HSCT), potential contributing factors and associated biomarkers, and avenues for further intervention and research.
Validation of a Post-Transplant Lymphoproliferative Disorder Risk Prediction Score and Derivation of a New Prediction Score Using a National Bone Marrow Transplant Registry Database
- Pages: e2034-e2041
- First Published: 10 September 2021
Post-transplant lymphoproliferative disorder (PTLD) refers to lymphoid and/or plasmacytic proliferations that develop after solid organ or allogeneic hematopoietic cell transplantation (HCT). This article reports a promising tool for risk stratification of patients receiving HCT that would allow for the identification of high-risk patients who may benefit from preemptive treatment for PTLD.
New Drug Development and Clinical Pharmacology
Impact of CYP2D6 Pharmacogenomic Status on Pain Control Among Opioid-Treated Oncology Patients
- Pages: e2042-e2052
- First Published: 23 August 2021
Some opioids have pharmacogenomic associations that affect analgesic efficacy; however, germline pharmacogenomic testing is not routinely incorporated into supportive oncology.This article evaluates the impact of CYP2D6 genotype on pain-related clinical outcomes in an oncology population.
Regulatory Issues: EMA
EMA Review of Isatuximab in Combination with Pomalidomide and Dexamethasone for the Treatment of Adult Patients with Relapsed and Refractory Multiple Myeloma
- Pages: 983-987
- First Published: 02 July 2021
This article summarizes the scientific review of the application leading to EMA regulatory approval of isatuximab combination therapy for multiple myeloma.
Sarcomas
Clinical Benefit of Ripretinib Dose Escalation After Disease Progression in Advanced Gastrointestinal Stromal Tumor: An Analysis of the INVICTUS Study
- Pages: e2053-e2060
- First Published: 27 July 2021
This article presents further results from the INVICTUS study, focusing on patients who received ripretinib 150 mg QD who received intrapatient dose escalation to 150 mg b.i.d. after progressive disease.
Symptom Management and Supportive Care
Retrospective Study of Bleeding Risk with Concomitant Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor and Anticoagulation
- Pages: e2061-e2069
- First Published: 05 July 2021
Patients with cancer are at higher risk for venous thromboembolism and bleeding, complicating anticoagulant therapy. This article assesses whether patients who received concomitant vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGF TKI) and anticoagulation were at higher risk for bleeding events compared with those who received a VEGF TKI alone.
Health-Related Quality of Life in Cancer Survivors with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Clinical Trial
- Pages: e2070-e2078
- First Published: 14 August 2021
Acupuncture is a promising and safe nonpharmacological approach to potentially address the unmet need for an effective treatment of chemotherapy-induced peripheral neuropathy. This article reports the results of a randomized sham acupuncture- and usual care-controlled clinical trial to evaluate the effect of acupuncture on health-related quality of life outcomes in patients with solid tumors dealing with chemotherapy-induced peripheral neuropathy.
Brief Communications
Ibritumomab Tiuxetan Radioimmunotherapy for Primary Gastrointestinal Follicular Lymphoma
- Pages: e2079-e2081
- First Published: 06 July 2021
This case series reports six cases of primary gastrointestinal follicular lymphoma treated with ibritumomab tiuxetan radioimmunotherapy, with good results.
Hypoxemic Respiratory Failure Following Ruxolitinib Discontinuation in Allogeneic Hematopoietic Cell Transplantation Recipients
- Pages: e2082-e2085
- First Published: 17 July 2021
Considering the increasing use of ruxolitinib in allogeneic hematopoietic cell transplantation recipients, this brief communication emphasizes the ongoing need to better characterize the biologic and clinical effects resulting from the discontinuation of ruxolitinib and to better tailor treatment plans and prevent potential adverse effects.
Molecular Spectra and Frequency Patterns of Somatic Mutations in Arab Women with Breast Cancer
- Pages: e2086-e2089
- First Published: 29 July 2021
Breast cancer in the Arab population has different clinicopathological and immunohistochemical features compared with the Western population. This article evaluates the frequency of somatic mutations identified using next-generation sequencing in a sample of Arab women with breast cancer.
Knowledge About Risks, Benefits, and Curative Potential of Immunotherapy Among Patients with Advanced Cancer
- Pages: e2090-e2093
- First Published: 18 August 2021
Individual experiences with immunotherapy are varied. This article describes patients’ knowledge about the risks, benefits, and goals of immunotherapy treatment.
Perspectives
COVID-19 Pandemic and Cancer: The Importance of Early Palliative Care
- Pages: e2094-e2096
- First Published: 04 November 2020
In terms of clinical and ethical situations, this narrative compares the COVID-19 pandemic to the cancer endemic and shares information that may be helpful to improve the management of both future pandemics and cancer care.
Narratives in Oncology
The Courage to Prevail
- Pages: 988-989
- First Published: 25 August 2021
This narrative tells the story of a boy who, with the help of his oncologists, parents, and community, conquered cancer.
Letters to the Editor
Regarding “Surgical Metastasectomy in the Spine: A Review Article”
- Pages: e2097
- First Published: 14 August 2021
This letter to the editor highlights recently published results of a study on total en bloc spondylectomy and its usefulness for improving function and survival in patients with spinal metastases.
In Reply
- Pages: e2098
- First Published: 16 August 2021
This letter to the editor responds to comments on a recently published review article on metastasectomy in the spine.