November 2018 Vol 9, NO 11

With the increasing cancer survivor population comes the need to develop recommendations about how to optimally care for these survivors.
Survivorship care recommendations exist to support a large and growing population of cancer survivors, yet little is known about survivors’ ongoing unmet needs.
In 2005, the Institute of Medicine published “From Cancer Patient to Cancer Survivor: Lost in Transition.” The report highlights the long-term medical and psychosocial consequences of cancer treatment and provides a foundation for survivorship programs today.
Thoracic surgeons remain involved with the long-term care of their cancer patients, usually in surveilling for recurrence. However, with an increasing survivor population, little is known on their other supportive needs.
Women diagnosed with breast cancer before age 45 face unique survivorship challenges, including early menopause, late effects of treatment, psychosocial distress, and sex and intimacy changes.
The phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) signaling pathway is frequently activated in breast cancer and can promote tumor growth, progression, and resistance to anticancer therapies such as endocrine therapy (ET).
Multiple tyrosine kinase inhibitors (TKIs) that target the BCR-ABL1 ATP-binding site are available for treating chronic myeloid leukemia (CML).
The COMBI-AD trial demonstrated that adjuvant treatment with dabrafenib + trametinib (D+T) in patients (pts) with resected stage III BRAF-mutant melanoma significantly reduced the risk of melanoma recurrence vs placebo (PBO).
Ribociclib combined with an aromatase inhibitor has been shown to significantly prolong progression-free survival (PFS) in premenopausal and postmenopausal women with hormone receptor–positive, human epidermal growth factor receptor 2–negative (HR+/HER2−) advanced breast cancer (ABC) who had not been treated previously for ABC.
Endocrine therapy (ET) is an established treatment for premenopausal women with hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2−) advanced breast cancer (ABC). MONALEESA-7 (NCT02278120) was the first phase 3 randomized trial of a cyclin-dependent kinases 4 and 6 inhibitor (ribociclib) + ET in premenopausal women with HR+/HER2− ABC without prior ET for ABC.
CheckMate 032 (NCT01928394) is an open-label, phase 1/2 trial evaluating the efficacy and safety of nivolumab monotherapy and nivolumab plus ipilimumab in patients with advanced or metastatic solid tumors. In this study, nivolumab alone or in combination with ipilimumab showed durable responses, encouraging survival, and manageable safety in patients with small cell lung cancer (SCLC) that progressed after ≥1 previous platinum-containing regimens.
Ibrutinib is an inhibitor of Bruton’s tyrosine kinase (BTK) that has demonstrated activity in relapsed Waldenström’s macroglobulinemia (WM). Single-agent ibrutinib is approved in the United States and Europe for WM.
Palbociclib is the first-in-class cyclin-dependent kinase 4/6 inhibitor approved in the United States in combination with an aromatase inhibitor (AI) or fulvestrant for treating patients with hormone receptor–positive (HR+), human epidermal growth factor receptor 2–negative (HER2–) advanced or metastatic breast cancer (mBC) as initial or later-line endocrine therapy. More than 80,000 patients have been treated in the United States with palbociclib since its approval in February 2015, but data on real-world palbociclib utilization are limited.
Ibrutinib is a first-in-class, once-daily inhibitor of BTK approved in the United States for treatment of CLL/SLL. RESONATE-2 is a phase 3 study comparing first-line ibrutinib versus chlorambucil in patients with CLL/SLL. Primary results (median follow-up, 18.4 months) demonstrated ibrutinib reduced risk of progressive disease (PD) or death by 84% (Burger, 2015).
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