Phase II trial of pembrolizumab and epacadostat in recurrent clear cell carcinoma of the ovary: An NRG oncology study GY016.

Introduction: Early reports of PD-1 inhibition in ovarian clear cell carcinomas (OCCC) demonstrate promising response. We evaluated the combination of pembrolizumab and IDO-1 inhibitor epacadostat in patients with recurrent OCCC.

Methods: This single arm, two-stage, phase 2 trial included those with measurable disease and 1-3 prior regimens.

Alliance for clinical trials in Oncology (Alliance) trial A022101/NRG-GI009: a pragmatic randomized phase III trial evaluating total ablative therapy for patients with limited metastatic colorectal cancer: evaluating radiation, ablation, and surgery (ERASur).

Background: For patients with liver-confined metastatic colorectal cancer (mCRC), local therapy of isolated metastases has been associated with long-term progression-free and overall survival (OS). However, for patients with more advanced mCRC, including those with extrahepatic disease, the efficacy of local therapy is less clear although increasingly being used in clinical practice. Prospective studies to clarify the role of metastatic-directed therapies in patients with mCRC are needed.

Electronic Patient Symptom Management Program to Support Patients Receiving Cancer Treatment at Home During the COVID-19 Pandemic.

Objectives: Remote patient monitoring became critical for patients receiving cancer treatment during the COVID-19 pandemic. We sought to test feasibility of an electronic patient symptom management program implemented during a pandemic. We collected and analyzed the real-world data to inform practice quality improvement and understand the patient experience.

Ultrastaging of 'negative' pelvic lymph nodes in patients with low- and intermediate-risk endometrioid endometrial cancer who developed non-vaginal recurrences.

Objective: Evidence on micrometastases and isolated tumor cells as factors associated with non-vaginal recurrence in low- and intermediate-risk endometrial cancer is limited. The goal of our study was to investigate risk factors for non-vaginal recurrence in low- and intermediate-risk endometrial cancer.

Methods: Records of all patients with endometrial cancer surgically managed at the Mayo Clinic before sentinel lymph node implementation (1999-2008) were reviewed.

Pretreatment with LCK inhibitors chemosensitizes cisplatin-resistant endometrioid ovarian tumors.

Background: Ovarian cancer is the most fatal gynecologic malignancy in the United States. While chemotherapy is effective in the vast majority of ovarian cancer patients, recurrence and resistance to standard systemic therapy is nearly inevitable. We discovered that activation of the non-receptor tyrosine kinase Lymphocyte Cell-Specific Protein-Tyrosine Kinase (LCK) promoted cisplatin resistance.

Thy-1 predicts poor prognosis and is associated with self-renewal in ovarian cancer.

Background: Ovarian cancer is the leading cause of gynecologic cancer death in the United States despite effective first-line systemic chemotherapy. Cancer stem cells (CSCs) retain the ability to self-renew and proliferate and may be a means of harboring disease that evades standard treatment strategies. We previously performed a high-throughput screen to assess differential protein expression in ovarian CSCs compared to non-CSCs and observed that Thy-1 was more highly expressed in CSCs.

The Stepped-Wedge Trial Design: Paving the Way for Cancer Care Delivery Research.

Cancer care delivery research (CCDR) is an emerging field that investigates ways to optimally provide care for patients within complex health-care systems. Novel research designs are essential to efficiently study CCDR research questions. A stepped-wedge trial (SWT) is one such pragmatic design and is similar to a parallel randomized controlled trial (RCT).

Pharmacologic Management of Cancer Pain.

Objective: To provide an overview of the pharmacologic management of cancer pain.

Data Sources: Peer-reviewed articles, textbooks, Internet.

Conclusion: Medications are the mainstay of cancer pain management.

First Report of NRG Oncology/Radiation Therapy Oncology Group 0622: A Phase 2 Trial of Samarium-153 Followed by Salvage Prostatic Fossa Irradiation in High-Risk Clinically Nonmetastatic Prostate Cancer After Radical Prostatectomy.

Purpose: To investigate the utility of Sm lexidronam (Quadramet) in the setting of men with prostate cancer status post radical prostatectomy who develop biochemical failure with no clinical evidence of osseous metastases.

Patients And Methods: Trial NRG Oncology RTOG 0622 is a single-arm phase 2 trial that enrolled men with pT2-T4, N0-1, M0 prostate cancer status post radical prostatectomy, who meet at least 1 of these biochemical failure criteria: (1) prostate-specific antigen (PSA) > 1.0 ng/mL; (2) PSA > 0.

Breathlessness with pulmonary metastases: a multimodal approach.

Case Study  Sarah is a 58-year-old breast cancer survivor, social worker, and health-care administrator at a long-term care facility. She lives with her husband and enjoys gardening and reading. She has two grown children and three grandchildren who live approximately 180 miles away.

Use of the National Cancer Institute Community Cancer Centers Program screening and accrual log to address cancer clinical trial accrual.

Purpose: Screening logs have the potential to help oncology clinical trial programs at the site level, as well as trial leaders, address enrollment in real time. Such an approach could be especially helpful in improving representation of racial/ethnic minority and other underrepresented populations in clinical trials.

Methods: The National Cancer Institute Community Cancer Centers Program (NCCCP) developed a screening log.

Fluid biopsy for solid tumors: a patient's companion for lifelong characterization of their disease.

Cancer is currently diagnosed and treated based on the results of a tissue biopsy of the primary tumor or a metastasis using invasive techniques such as surgical resection or needle biopsy. New technology for retrieving cancer cells from the circulation, developed in the last 5 years, has made it possible to obtain a 'fluid biopsy' from the bloodstream without the need for an invasive procedure. This technological development makes it possible to diagnose and manage cancer from a blood test rather than from a traditional biopsy.

Informed consent and patients with cancer: role of the nurse as advocate.

Informed consent is an ongoing process, and oncology nurses are important advocates to identify information gaps and patient concerns during this process. This article discusses the rights of research participants from a regulatory perspective. Two case scenarios are presented and discussed to describe how nurses can ensure that patients are truly informed and understand the clinical trial process.

High-definition imaging of circulating tumor cells and associated cellular events in non-small cell lung cancer patients: a longitudinal analysis.

Sampling circulating tumor cells (CTCs) from peripheral blood is ideally accomplished using assays that detect high numbers of cells and preserve them for downstream characterization. We sought to evaluate a method using enrichment free fluorescent labeling of CTCs followed by automated digital microscopy in patients with non-small cell lung cancer. Twenty-eight patients with non-small cell lung cancer and hematogenously seeded metastasis were analyzed with multiple blood draws.

Symptom trajectories during chemotherapy in outpatients with lung cancer colorectal cancer, or lymphoma.

Purpose: Pain, depression, distress, fatigue, and sleep disturbance are common symptoms in oncology patients, but little data are available that examine the trajectories of these symptoms during chemotherapy (CTX). The purposes of this study were to examine the trajectories of these symptoms during the first six cycles of CTX and to determine whether individual characteristics predicted the trajectories of these symptoms.

Methods: Oncology outpatients (n = 118) with newly diagnosed lung cancer, colorectal cancer, or lymphoma rated symptoms using an electronic patient care monitor system.

Palliative care for adults across the cancer trajectory: from diagnosis to end of life.

Objectives: To provide an overview of palliative care across the cancer trajectory from diagnosis through treatment, the chronic phase, and end of life.

Data Sources: Journal articles, research reports, state of the science papers, and clinical practice experience and guidelines.

Conclusion: Symptoms occur throughout the cancer trajectory but are more common during active treatment and at the end of life.

Symptom trajectories in posttreatment cancer survivors.

Background: Cancer survivorship following cancer treatment is uncertain as physical and psychological sequelae related to the disease or its treatment may persist. However, little is known about the experience of symptoms after treatment.

Objectives: The purposes of this study were to (1) examine postchemotherapy (post-CTX) symptom trajectories in cancer survivors and (2) determine whether demographic characteristics predicted symptom trajectories.

Building dynamic models and theories to advance the science of symptom management research.

Aim: This paper is a description, comparison, and critique of two models and two theories used to guide symptom management research, and a proposal of directions for new theory or model development.

Background: Symptom management research has undergone a paradigmatic shift to include symptom clusters, longitudinal studies that examine symptom trajectories, and the effects of interventions on patient outcomes. Models and theories are used to guide descriptive and intervention research.

The global experience of cancer pain.

Pain is a significant problem in patients with cancer. Pain occurs in approximately 50% of patients at some point during the disease process and in up to 75% of patients with advanced cancer. Total pain impacts quality of life domains including physical, psychological, social, and spiritual realms.