Latest Cancer News

What to Tell Children when Facing a Diagnosis of Cancer

If you have children in your life, you already know that they tend to be creatures of habit who rely on their daily routine. There may be unexpected changes in their routine with your fight against cancer, and you may be concerned about the best way to talk to them about it. Whether you’re a parent or have children you love in your life, you probably already know how children can react to different types of stress. In order to set things on the right track, it’s best to be open and honest with them. If you have children in school, it’s also a good idea to inform your children’s teachers or other care providers that your children may be facing some tough challenges. Here are some informative tips to help the children in your life understand what is going on:

  • Hold regular family meetings to discuss your diagnosis, how treatments are going, and what your doctors are telling you.
  • If you are unable to go to your children’s special events—like games or school plays—have another parent tape the event so you can watch it with your children at a later date.
  • Reassure children that you did not get cancer because of something they did. Also be sure to let them know that you cannot “catch” cancer like you can catch a cold.
  • Make every effort to be there for the children in your life—as long as your doctor says it’s safe to do so. For the times you can’t be there, send along a good luck note to let them know that you care.

While it might take your children a little while to adapt, your honesty and love will help them through this difficult and challenging time.

Copyright © 2017 CancerConnect. All Rights Reserved.


Acupuncture Reduces Aromatase Inhibitor Joint Pain in Women with Breast Cancer

According to a well designed study presented at the 2017 San Antonio Breast Cancer Symposium acupuncture is effective in reducing pain and stiffness associated with aromatase inhibitor (AI) therapy in women with early-stage breast cancer.1

Stiffness and joint pain is a well documented concern of women undergoing AI therapy for the treatment and prevention of breast cancer that may contribute to non-compliance or the discontinuation of treatment.

Understanding Acupuncture

In order to formally evaluate acupuncture as a treatment of AI associated joint pain researchers designed and completed a clinical trail to be performed in women with early stage breast cancer taking a third-generation AI and experiencing joint pain.  The study enrolled 226 patients who were treated with one of the following approaches:

  • True acupuncture: a 30- to 45-minute session including a full body, auricular, and joint-specific acupuncture protocol tailored to the most painful joints.
  • Sham acupuncture: shallow needle insertion with thin, short needles at 4 standardized non-acupuncture points.
  • Waitlist control: patients were under the impression they would receive true acupuncture following the 24-week trial.

The study revealed that following 6 weeks of treatment pain decreased significantly in the “true acupuncture” treated women compared to the “sham acupuncture” and “waitlist control” groups.  True acupuncture also demonstrated a greater proportion of patients reporting clinically meaningful reductions in the severity of pain.

The study confirms that acupuncture provides a safe and effective alternative treatment that can relieve joint symptoms and possibly increase AI adherence in women with early stage breast cancer.

What Other Symptoms can Acupuncture Relieve?

Reference: Hershman DL, Unger JM, Greenlee H, et al. Randomized blinded sham- and waitlist-controlled trial of acupuncture for joint symptoms related to aromatase inhibitors in women with early stage breast cancer (S1200). Presented at: 2017 San Antonio Breast Cancer Symposium; Dec. 5-9, 2017; San Antonio, TX. Abstract GS4-04. abstracts2view.com/sabcs/view.php?nu=SABCS17L_503&terms=

Copyright © 2017 CancerConnect. All Rights Reserved.


Questions to Ask Before Radiation Therapy for the Treatment of Cervical Cancer

Radiation therapy, or radiotherapy, is a common way to treat cervical cancer. Doctors who specialize in treating cancers with radiation are known as radiation oncologists. During radiation therapy, high-energy x-rays are used to kill cancer cells. Radiation therapy can be given by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly into the cervix (internal or implant radiation or brachytherapy). Many patients receive both kinds of radiation therapy. For stage I cervical cancer, radiation therapy may be used instead of surgery or it may be used after surgery to destroy remaining cancer cells. For stages IB-IVA cervical cancer, radiation therapy is usually administered concurrently with chemotherapy.

Although patients do not feel anything while receiving radiation treatment, the effects of radiation gradually build up over time. Many patients become tired as treatment continues. Loose stools and diarrhea are also common. Urination may become more frequent or uncomfortable. Some patients may experience loss of pubic hair or irritation of the skin. After the radiation therapy is completed, the vagina can become narrower and less flexible. Finally, radiation therapy to the pelvis can stop the ovaries from functioning, thereby causing younger women to enter menopause early and subsequently be infertile.

With any treatment of cancer, you must first understand your responsibility, your medical team’s role, explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of radiation can be significant, talk to your doctor before treatment begins so that you understand the specific kind of radiation you will receive and the expected side effects. The following list of questions is meant as a guide to issues you should discuss with your radiation oncologist and medical team before undergoing radiation therapy for cervical cancer.

Questions to Ask When Exploring Your Options

  • What is the stage of my cancer?
  • Why do you recommend radiation?
  • What are my options besides radiation?
  • Is radiation the standard therapy for my stage of disease?
  • Are there clinical trials for my stage of disease?
  • Will I have chemotherapy concurrently with radiation?
  • Are there any protocols for neoadjuvant therapy for my stage of disease?
  • Are there any pre-radiation procedures I might benefit from to protect my fertility?

Questions to Ask about Radiation

  • What is your experience with complications from radiation?
  • What should I expect as far as complications and side effects?
  • Considering my age and general health, am I at higher or lower risk for complications and side effects?
  • Will my radiation treatments be external, internal or both?
  • How many treatments will I have?
  • How will the treatments be administered?
  • If I have both external and internal radiation, what type of internal radiation is used and when?
  • During external radiation treatments, do you use shields to protect the small bowel and other organs?
  • Will the beam be directed at all four sides (front, back, and laterals) to help diminish side effects?
  • If, for modesty reasons, I am uncomfortable having male technicians, is it possible to have only female technicians attend me during my treatments?
  • Have my radiation treatments been approved by my insurance?

Questions to Ask about Side Effects

  • What are the expected side effects and how do I deal with them?
  • Are the treatments painful?
  • How will treatment affect my sexuality, both long and short term?
  • Do you recommend use of a vaginal dilator? If so, how and when should I use it?
  • Do you prescribe medications to help me with emotional issues?
  • Will I get advice on my diet and supplemental nutrition from a registered nutritionist?
  • Will I get advice on caring for the radiated area from an oncology nurse?

Questions to Ask about Recovery

  • How long will my recovery take when I have completed my radiation treatment?
  • Who can I call with questions or concerns?
  • If my radiation therapy induces menopause, would I benefit from estrogen replacement therapy?
  • Who will be my follow-up doctor?

Determining that radiation therapy is the right treatment for you, as well as asking your radiation oncologist about treatment procedures and side effects are critical to making informed decisions about your disease. Exploring emotional and physical side effects of radiation therapy will give you some insight into potential problems before they occur. Although managing and living with these side effects may still be difficult, at least you will be aware and informed if they occur. Before undergoing any treatment for you disease you should understand your responsibility, your medical team’s role, explore treatment options, ask questions and get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to CancerConnect.com, www.cancer.gov, and consult your physician.

Questions to Ask Before Radiation Therapy for the Treatment of Cervical Cancer

Radiation therapy, or radiotherapy, is a common way to treat cervical cancer. Doctors who specialize in treating cancers with radiation are known as radiation oncologists. During radiation therapy, high-energy x-rays are used to kill cancer cells. Radiation therapy can be given by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly into the cervix (internal or implant radiation or brachytherapy). Many patients receive both kinds of radiation therapy. For stage I cervical cancer, radiation therapy may be used instead of surgery or it may be used after surgery to destroy remaining cancer cells. For stages IB-IVA cervical cancer, radiation therapy is usually administered concurrently with chemotherapy.

Although patients do not feel anything while receiving radiation treatment, the effects of radiation gradually build up over time. Many patients become tired as treatment continues. Loose stools and diarrhea are also common. Urination may become more frequent or uncomfortable. Some patients may experience loss of pubic hair or irritation of the skin. After the radiation therapy is completed, the vagina can become narrower and less flexible. Finally, radiation therapy to the pelvis can stop the ovaries from functioning, thereby causing younger women to enter menopause early and subsequently be infertile.

With any treatment of cancer, you must first understand your responsibility, your medical team’s role, explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of radiation can be significant, talk to your doctor before treatment begins so that you understand the specific kind of radiation you will receive and the expected side effects. The following list of questions is meant as a guide to issues you should discuss with your radiation oncologist and medical team before undergoing radiation therapy for cervical cancer.

Questions to Ask When Exploring Your Options

  • What is the stage of my cancer?
  • Why do you recommend radiation?
  • What are my options besides radiation?
  • Is radiation the standard therapy for my stage of disease?
  • Are there clinical trials for my stage of disease?
  • Will I have chemotherapy concurrently with radiation?
  • Are there any protocols for neoadjuvant therapy for my stage of disease?
  • Are there any pre-radiation procedures I might benefit from to protect my fertility?

Questions to Ask about Radiation

  • What is your experience with complications from radiation?
  • What should I expect as far as complications and side effects?
  • Considering my age and general health, am I at higher or lower risk for complications and side effects?
  • Will my radiation treatments be external, internal or both?
  • How many treatments will I have?
  • How will the treatments be administered?
  • If I have both external and internal radiation, what type of internal radiation is used and when?
  • During external radiation treatments, do you use shields to protect the small bowel and other organs?
  • Will the beam be directed at all four sides (front, back, and laterals) to help diminish side effects?
  • If, for modesty reasons, I am uncomfortable having male technicians, is it possible to have only female technicians attend me during my treatments?
  • Have my radiation treatments been approved by my insurance?

Questions to Ask about Side Effects

  • What are the expected side effects and how do I deal with them?
  • Are the treatments painful?
  • How will treatment affect my sexuality, both long and short term?
  • Do you recommend use of a vaginal dilator? If so, how and when should I use it?
  • Do you prescribe medications to help me with emotional issues?
  • Will I get advice on my diet and supplemental nutrition from a registered nutritionist?
  • Will I get advice on caring for the radiated area from an oncology nurse?

Questions to Ask about Recovery

  • How long will my recovery take when I have completed my radiation treatment?
  • Who can I call with questions or concerns?
  • If my radiation therapy induces menopause, would I benefit from estrogen replacement therapy?
  • Who will be my follow-up doctor?

Determining that radiation therapy is the right treatment for you, as well as asking your radiation oncologist about treatment procedures and side effects are critical to making informed decisions about your disease. Exploring emotional and physical side effects of radiation therapy will give you some insight into potential problems before they occur. Although managing and living with these side effects may still be difficult, at least you will be aware and informed if they occur. Before undergoing any treatment for you disease you should understand your responsibility, your medical team’s role, explore treatment options, ask questions and get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to CancerConnect.com, www.cancer.gov, and consult your physician.

Copyright © 2017 CancerConnect. All Rights Reserved.


Addition of Darzalex™ Improves Outcomes in Newly Diagnosed Multiple Myeloma

The addition of Darzalex™ (daratumumab) to the standard treatment combination consisting of Velcade (bortezomib), melphalan, and prednisone (VMP) reduces disease progression or death by 50%, among patients with newly diagnosed multiple myeloma who are not eligible to undergo a stem cell transplant. These results were presented as a late-breaking abstract at the 2017 annual meeting of the American Society of Hematology.

In the United States alone, approximately 30,000 people will be diagnosed with multiple myeloma in the year 2017. Multiple myeloma is a type of cancer that starts in immune cells called plasma cells. Treatment varies according to the extent or aggressiveness of the disease, as well as the patient’s other existing medical conditions or ability to tolerate some types of therapies.

About Darzalex™ (daratumumab)

Darzalex™ is a monoclonal antibody that has been produced in a laboratory to bind to a protein often found on the surface of multiple myeloma cancer cells, called CD38. The binding of Darzalex™ has direct killing effects on the cell, as well as stimulating effects on the immune system to attack the cancer cell. Darzalex™ is approved for the treatment of multiple myeloma in combinations with different types of treatment regimens among patients whose cancer has progressed following therapy.

Researchers recently conducted a clinical trial to evaluate the addition of Darzalex™ to VMP among patients who had not yet received prior treatment, and were not eligible for a stem cell transplant. Patients in the trial were at least 65 years of age and were divided into two groups: one group was treated with Darzalex™ plus VMP (D-VMP), and the other group was treated with VMP only.  Data was retrieved at a median follow-up of 16.5 months following initiation of treatment.

  • Patients treated with D-VMP had a 50% reduction in their risk of death or disease progression, compared to those treated with VMP only.
  • Treatment benefit of D-VMP remained among all treatment groups: for patients 75 years of age and older; for patients with later-stage multiple myeloma; and for patients whose genetic analysis determined that they were at a high risk for a cancer recurrence.
  • At this time, overall survival data are too immature to determine true overall survival differences between the two groups of patients.

The researchers concluded that the addition of Darzalex™ to VMP among patients who have not received prior therapy, but are not eligible for a stem cell transplant, significantly reduces their risk of death or disease progression. Longer follow-up will help determine potential survival benefits for this group of patients.

Reference: Mateos M-V, Dimopoulos M, Cavo M, et al. Phase 3 randomized study of Darzalex™  plus bortezomib, melphalan, and prednisone (D-VMP) versus bortezomib, melphalan, and prednisone (VMP) in newly diagnosed multiple myeloma (NDMM) patients (pts) ineligible for transplant (ALCYONE). Proceedings from the 59th annual meeting and exhibition of the American Society of Hematology; Atlanta, GA; December 9-12, 2017; Late-breaking abstract #4. Retrieved from https://ash.confex.com/ash/2017/webprogram/Paper109143.html

Copyright © 2017 CancerConnect. All Rights Reserved.


Mogamulizumab Superior to Vorinostat in Cutaneous T Cell Lymphoma

Results were recently presented at the 59th American Society of Hematology (ASH) Annual Meeting and Exposition in Atlanta from a international comparative clinical trail evaluating mogamulizumab in patients with previously treated cutaneous T-cell lymphoma (CTCL).

Precision cancer medicine utilizes molecular diagnostic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack the cancer cells with specific abnormalities, leaving normal cells largely unharmed.  Because they are designed to specifically target cancer cells while leaving normal cells alone, targeted therapies usually have different, and sometimes milder, adverse side effects than standard chemotherapy drugs.

CTCL is a rare cancer of the white blood cells, specifically T lymphocytes, that primarily occurs in the skin. It is caused when T cells (cells in the immune system that help the body fight infection) begin to grow uncontrollably and build up in the skin. CTCL can also involve the blood, lymph nodes, and internal organs.

Mogamulizumab is a novel precision cancer medicine that is given intravenously and targets a protein (CCR4) that is frequently found on the surface of cancer cells in patients with CTCL. As a CCR4 antibody, the drug exploits the patient’s immune cells to attack the cancer.

In a head to head comparison the study found that the precision cancer medicine mogamulizumab improved progression-free survival, response rate, and quality of life compared to Zolinza™ (vorinostat), a U.S. Food and Drug Administration (FDA)-approved standard-of-care treatment for patients with CTCL.  Mogamulizumab

Reference

Anti-CCR4 Monoclonal Antibody, Mogamulizumab, Demonstrates Significant Improvement in PFS Compared to Vorinostat in Patients with Previously Treated Cutaneous T-Cell Lymphoma (CTCL): Results from the Phase III MAVORIC Study [817]

Copyright © 2017 CancerConnect. All Rights Reserved.


Kisqali® Improves Outcomes of Premenopausal Women with HR+/HER2- Advanced Breast Cancer

It was announced today that results from the Phase III MONALEESA-7 trial evaluating Kisqali® (ribociclib) in combination endocrine-based therapy in premenopausal or perimenopausal women with hormone-receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer will be presented as a late-breaking oral presentation at the 2017 Annual San Antonio Breast Cancer Symposium.  Kisqali significantly prolonged progression-free survival (PFS) compared to endocrine therapy alone.1

About Kisqali® 
Kisqali is a selective cyclin-dependent kinase inhibitor, a class of drugs that help slow the progression of cancer by inhibiting two proteins called cyclin-dependent kinase 4 and 6 (CDK4/6). These proteins, when over-activated, can enable cancer cells to grow and divide too quickly. Targeting CDK4/6 with enhanced precision may play a role in ensuring that cancer cells do not continue to replicate uncontrollably.

About MONALEESA-7

MONALEESA-7 is a comparative clinical trial designed to evaluate Kisqali in combination with hormone therapy consisting of tamoxifen or a non-steroidal aromatase inhibitor plus goserelin compared to treatment with tamoxifen or an aromatase inhibitor plus goserelin alone, in premenopausal or perimenopausal women with HR+/HER2- advanced breast cancer in women who had not previously received endocrine therapy for advanced disease.

Kisqali in combination with tamoxifen or an aromatase inhibitor plus goserelin demonstrated an improved time of survival without cancer progression of 23.8 months compared to 13.0 months for tamoxifen or an aromatase inhibitor plus goserelin.  Premenopausal women treated with the Kisqali combination therapy saw a response as early as eight weeks.

The Kisqali combination was well tolerated and women taking Kisqali also had a clinically meaningful improvement in pain symptoms as early as eight weeks; this improvement was sustained.  The most significant side effect observed in patients receiving Kisqali combination therapy compared to endocrine therapy alone was neutropenia which occurred in 60.6% compared to 3.6% of endocrine only treated patients.

Premenopausal breast cancer is a biologically distinct and more aggressive disease than postmenopausal breast cancer, and it is the leading cause of cancer death in women 20-59 years old.2,3 The Kisqali combination therapy represents a new and improved treatment option for these women.

References:

  1. Tripathy D, Sohn J, Im S, et al. First-line ribociclib or placebo combined with goserelin and tamoxifen or a non-steroidal aromatase inhibitor in premenopausal women with hormone receptor-positive, HER2-negative advanced breast cancer: results from the randomized Phase III MONALEESA-7 trial. Presented at the San Antonio Breast Cancer Symposium (SABCS), December 6, 2017, San Antonio, Texas (abstract#S2-05).
  2. Benz CC. Impact of aging on the biology of breast cancer. Crit Rev Oncol Hematol. 2008;66:65-74
  3. World Health Organization. Women’s health fact sheet. September 2013. Available at http://www.who.int/mediacentre/factsheets/fs334/en/. Accessed October 2017.

Copyright © 2017 CancerConnect. All Rights Reserved.


Keytruda Immunotherapy Shows Promise for Patients With Herceptin-resistant Breast Cancer

A combination of Keytruda (pembrolizumab) and Herceptin (trastuzumab), tested in patients with Herceptin-resistant advanced HER2-positive breast cancer, was well tolerated and had clinical benefit in patients whose tumors were positive for a biomarker for Keytruda, according to data presented at the 2017 San Antonio Breast Cancer Symposium.

About HER2-Positive Breast Cancer

About one in five patients with breast cancer overexpress HER2, a tyrosine kinase receptor growth-promoting protein found on the surface of some cancer cells, which is associated with aggressive disease.2   Many tumors advance to the point where no currently approved HER2-targeting treatment continues to control the disease. Furthermore, there is no standard of care for HER2-positive tumors following treatment with Herceptin.3  Herceptin targets and blocks the HER2-protein, and is used for the treatment of both early-stage and more advanced HER2-positive breast cancer. Some patients however develop resistance to Herceptin.

About Keytruda

The cancer immunotherapy strategy known as programmed cell death 1 (PD-1) has generated great excitement for its ability to help the immune system recognize, and attack cancer.

Keytruda is a fully humanized monoclonal antibody that binds with high-affinity to the PD-1 receptor that helps to restore the body’s immune system in fighting cancer. It creates its anti-cancer effects by blocking a specific protein used by cancer cells called PD-L1, to escape an attack by the immune system.  PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1 are called checkpoint inhibitors and enhance the ability of the immune system to fight cancer.  Once PD-L1 is blocked, cells of the immune system are able to identify cancer cells as a threat, and initiate an attack to destroy the cancer.

The current clinical trial enrolled patients with advanced breast cancer that had progressed on prior Herceptin based therapies; 40 and 12 patients respectively to the PDL1-positive and PDL1-negative groups. Patients received Keytruda every three weeks in combination with the standard dose of Herceptin for 24 months or until disease progression.

Patients in the PD-L1 positive group had an objective response rate of 15% and a disease control rate of 25% was observed. In a subgroup of PD-L1-positive patients with 5 percent or more (tumor infiltrating lymphocytes) TILs present the overall response rate was 39% and the disease control rate was 47%.

Tumor-infiltrating lymphocytes are mononuclear immune white blood cells that have left the bloodstream and can often be found and measured in the cancer. The presence of TILS is often associated with better clinical outcomes after surgery or immunotherapy.4 Measurement of TILs may help identify patients who will most benefit from this treatment. No responses were observed in PD-L1 negative patients.

The study authors concluded that this proof-of-principle study suggests that immune evasion may be a method of Herceptin resistance and that PD1 inhibition is likely to become part of the treatment armamentarium of HER2-positive disease in the future.

Reference:

  1. Loi S, Giobbie-Hurder A, Gombos A, et al. Phase Ib/II study evaluating safety and efficacy of pembrolizumab and trastuzumab in patients with trastuzumab-resistant HER2-positive advanced breast cancer: results from the PANACEA study (IBCSG 45-13/BIG 4-13/KEYNOTE-014). Presented at: 2017 San Antonio Breast Cancer Symposium; December 5-9, 2017; San Antonio, TX. Abstract GS2-06.
  2. American Cancer Society. Breast Cancer Overview. 2016.
  3. NCCN Guidelines. Breast Cancer. Version 2.2017.
  4. Zhang L, Conejo-Garcia JR, Katsaros D, et al. (January 2003). “Intratumoral T cells, recurrence, and survival in epithelial ovarian cancer”. The New England Journal of Medicine. 348 (3): 203–13. doi:1056/NEJMoa020177. PMID12529460.

Copyright © 2017 CancerConnect. All Rights Reserved.


FDA and CMS Collaborate to Make Novel Cancer Biomarker Test Available

The U.S. Food and Drug Administration (FDA) has approved the F1CDx biomarker test designed to detect mutations in 324 genes and two genomic signatures in cancer patients. In a truly collaborative effort between the FDA and The Centers for Medicare & Medicaid Services (CMS) the latter proposed coverage of the F1CDx test under the new FDA and CMS Parallel Review Program.  The program was designed to facilitate earlier access to innovative medical technologies for Medicare beneficiaries.

About F1CDx

The F1CDx is a first of its kind extensive test that provides information on a number of different genetic mutations that may help in the clinical management of patients with cancer. Additionally, based on individual test results, the new diagnostic can identify which patients with any of five tumor types may benefit from 15 different FDA-approved targeted treatment options.

The device works by sequencing DNA from a patient’s tumor sample to determine the presence of gene mutations and alterations. It also detects certain molecular changes (microsatellite instability and tumor mutation burden). Clinical performance of the test was established through a least burdensome means by comparing the F1CDx to previously FDA-approved companion diagnostic tests that are currently used to determine patient eligibility for certain treatments. Results indicated that the test’s ability to detect select mutation types (substitutions and short insertions and deletions) representative of the entire 324 gene panel is accurate approximately 94.6 percent of the time.

The new FDA Commissioner Scott Gottlieb MD stated “By leveraging two policy efforts aimed at expediting access to promising new technologies, we’ve been able to bring patients faster access to a breakthrough diagnostic that can help doctors tailor cancer treatments to improve medical outcomes and potentially reduce health care costs.” The FDA’s Breakthrough Device Program and Parallel Review with CMS allowed the developers to win approval for this novel diagnostic and secure an immediate proposed Medicare coverage and thus providing access to patients in need must faster than has been done previously.

“Through parallel review and collaboration, we speed access to innovative diagnostics, so that doctors are better able to deliver the best quality care to their patients and patients have access to these state-of-the-art tests,” said Seema Verma, Administrator of CMS.

Learn more about biomarker testing and precision cancer medicine

The F1CDx detects gene mutations that may be found in any solid tumor and this information can be used by physicians according to professional guidelines to manage cancer patients. Moreover, it can be used as a companion diagnostic to identify patients with specific mutations who may benefit from certain FDA-approved treatments for non-small cell lung cancer, melanoma, breast cancer, colorectal cancer or ovarian cancer. Importantly, the F1CDx can detect genetic mutations that are indicated for multiple FDA-approved treatments, which extends beyond the previous “one test for one drug” model.

Reference:

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm587273.htm

Copyright © 2017 CancerConnect. All Rights Reserved.


Managment of the Side Effects of Radiation for Cervical Cancer

Radiation therapy, or radiotherapy, is a common way to treat cervical cancer. With any treatment of cancer you must first understand your responsibility and your medical team’s role as well as explore treatment options and get a second opinion(s) before you begin treatment. Since the side effects of radiation can be significant, talk to your doctor prior to treatment so that you understand the specific kind of radiation you will receive and the expected side effects. Doctors who specialize in treating cancers with radiation are known as radiation oncologists. During radiation therapy, high-energy x-rays are used to kill cancer cells. Radiation therapy can be given by a machine that aims x-rays at the body (external beam radiation) or by placing small capsules of radioactive material directly into the cervix (internal or implant radiation or brachytherapy). Many patients receive both kinds of radiation therapy. For stage I cervical cancer, radiation therapy may be used instead of surgery or it may be used after surgery to destroy remaining cancer cells. For stages IB-IVA cervical cancer, radiation therapy is usually administered concurrently with chemotherapy.

Although patients do not feel anything while receiving radiation treatment, the effects of radiation gradually build up over time. Many patients become tired as treatment continues. Loose stools or diarrhea is also common. Urination may become more frequent or uncomfortable. Some patients may experience loss of pubic hair or irritation of the skin. After the radiation therapy is completed, the vagina can become narrower and less flexible. Finally, radiation therapy to the pelvis can stop the ovaries from functioning, thereby causing younger women to enter menopause early and subsequently be infertile.

Fatigue from radiation therapy can be a cumulative result of the stress from your disease, daily trips for radiation treatment and radiation effects on normal cells in the body. Patients vary in their degree of fatigue and their toleration of a normal work schedule and activities. Some patients suggest that a flexible work schedule is important since fatigue is more noticeable after the first couple of weeks of radiation therapy. Patients who were in a very stressful, high demand job suggested taking time off from work. On the other hand, patients who enjoyed their job suggested maintaining a regular work schedule or adjusted schedule to benefit from some degree of normalcy. In addition, patients suggest taking naps, getting adequate sleep, light exercise and some limitation of normal activities to help with fatigue. Check with your doctor to see what his or her recommendations are for exercise, activities and work load.

Diarrhea and loose stools may be a common temporary side effect or uncommon longer lasting side effect due to the radiation of the pelvis. Managing diarrhea may require anti-diarrhea medication and following nutritional recommendations by your doctor. Avoiding foods high in fiber like raw vegetables, fruit, grains and cereals may decrease the occurrence of diarrhea. A liquid diet at the onset of diarrhea may also help to reduce the occurrence. Check with your doctor for specific medication and nutritional recommendations.

Frequent and uncomfortable urination may be alleviated by drinking a lot of fluids, but avoiding caffeine and carbonated beverages. Your doctor may also prescribe medication to help relieve urination difficulty side effects.

Irritation of the skin is another common side effect associated with radiation therapy. Your doctor may be able to prescribe anti-itch medication for severe itching and irritation. Avoiding unnecessary irritation of the radiated area will also prevent further discomfort. Avoid lotion application within 2 hours of treatment, very hot or very cold water, sun exposure, tight clothing and scratching or scrubbing the affected area. Also, ask your doctor to recommend skin care products that will not irritate the tender skin. Most skin reactions will go away when treatment is over.

Shrinking and scarring (stenosis) of vaginal tissue associated with radiation therapy of the pelvis can be a difficult long-term side effect. This can make sexual relations painful and make future pelvic examinations difficult. In order to manage this side effect, it is important to maintain the pliability of the vagina with frequent sexual intercourse or the use of a dilator. Lubricants and creams may also help with vaginal dryness and sexual function.

Pelvic radiation for the treatment of cervical cancer can cause the ovaries to stop working either temporarily or permanently. In women of child-bearing age, early menopause inducement results from ovarian function cessation. There are many side effects of early menopause ranging from irregular periods, hot flashes and vaginal dryness to infertility and emotional issues. Hormone replacement therapy and other alternative methods may be recommended by your gynecologist to help manage the side effects of early menopause.

The potential loss of fertility associated with ovarian dysfunction resulting from radiation therapy should be discussed with your doctor before treatment begins. Some patients may want to have their eggs harvested for surrogacy before radiation treatment. Also, a highly experimental approach is currently being explored that involves removing an ovary and implanting it in an area of the body that will not be affected by the radiation treatment. This experimental approach may one day be offered to help avoid infertility and early menopause associated with radiation therapy of the pelvis.

Radiation is a common form of therapy in the treatment of cervical cancer. The potential short-term side effects may cause varying degrees of discomfort that can be managed by you and your doctor. Potential long-term effects such as early induced menopause, infertility, vaginal stenosis and bowel problems are reportedly the most difficult for patients to deal with emotionally and physically. Support groups, family support or professional support may help patients cope with these side effects. To understand the specific kind of radiation you will receive and the expected side effects, ask questions and use sources including your medical team, books, the Internet and other people with your disease. Before undergoing any treatment you should understand your responsibility, your medical team’s role, explore treatment options and get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to CancerConnect.com,www.cancer.gov, and consult your physician.

Copyright © 2017 CancerConnect. All Rights Reserved.


Fedratinib May Represent New Option for Jakafi-Resistant Myelofibrosis

Patients with myelofibrosis resistant or intolerant to Jakafi (ruxolitinib) may have an alternative treatment option with a novel JAK2-selective inhibitor fedratinib, according to the results of clinical study recently published in the medical journal Lancet.1

About Myelofibrosis

Myelofibrosis is a type of blood cancer known as a myeloproliferative neoplasm that is chronic and progressive in nature. It involves the abnormal development and function of bone marrow cells that produce blood cells and leads to the formation of scar tissue in the bone marrow. When the bone marrow becomes scarred it can’t make enough blood cells and this can cause anemia, enlargement of the spleen and liver, fatigue, and other problems.

Myelofibrosis can result from a worsening of other bone marrow diseases, such as polycythemia vera and essential thrombocythemia or develop on its own – so called primary myelofibrosis.

Approved in 2011, Jakafi is currently the only drug that has been approved specifically for myelofibrosis. Known as a JAK inhibitor, it is a targeted therapy that improves survival and can help to relieve the signs and symptoms of myelofibrosis, such as enlargement of the spleen, night sweats, itching, and bone or muscle pain.2

Janus-associated kinases 1 and 2 mediate the signaling of cytokines and growth factors important for blood production and immune function. The JAK1/JAK2 cellular pathway has demonstrated activity involved in the progression of Myelofibrosis.  Medications such as Jakafi and fedratinib block the activity of the JAK1/JAK2 pathway which reduces the negative effects caused by its activity and are referred to as JAK inhibitors. Some patients treated with Jakafi do not achieve a reduction in spleen volume and about one-half will discontinue treatment after 3 to 5 years.  Fedratinib inhibits the JAK 2 kinase and may represent a treatment option for these patients.

In the current study doctors investigated the effectiveness and safety of fedratinib in 97 patients with either primary myelofibrosis or those developing myelofibrosis after polycythemia, or essential thrombocytopenia who were either intolerant or resistant to treatment with Jakafi.

Overall fedratinib was effective in reducing splenomegaly and symptom burden in patients who had previously discontinued Jakafi therapy due to either intolerance or resistance.  By 6 months, 55% of all patients achieved a reduction in spleen size spleen and 53% of the Jakafi resistant and 63% of the Jakafi intolerant patients ultimately achieved a response to treatment.  About one-quarter (26%) of patients achieved a 50% or greater reduction in total symptom score compared with baseline.

Currently under review by the FDA, fedratinib may soon represent an effective treatment option for selected individuals with myelofibrosis.

References:

  1. http://www.thelancet.com/pdfs/journals/lanhae/PIIS2352-3026(17)30088-1.pdf
  2. http://news.cancerconnect.com/5-year-survival-improved-early-use-jakafi-myelofibrosis/

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