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issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

immunotherapy
lung cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

lung cancer
immunotherapy

Corticosteroid Use at Start of PD-1/PD-L1 Inhibitor Therapy Affects Outcomes in NSCLC

IN A STUDY reported in the Journal of Clinical Oncology, Kathryn C. Arbour, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1/programmed cell death ligand 1...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology
cost of care

Tackling Financial Toxicity: One Institution’s Roadmap Forward

  ALTHOUGH FINANCIAL toxicity has become an important issue in the oncology community, evidence suggests the subject is rarely addressed by oncologists, exacerbating its grave effects on patients with cancer and their families.1 “But I don’t think it’s because health-care providers don’t want to...

leukemia
lymphoma

Venetoclax for CLL or SLL With or Without 17p Deletion After Prior Therapy

On June 8, 2018, venetoclax (Venclexta) was granted regular approval for treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on ...

issues in oncology

Do Incident Learning Systems Prevent Medical Errors?

ACCORDING TO a study by Johns Hopkins, medical errors are the third leading cause of death in the United States.1 Lakshmi Santanam, PhD, tackled such sobering data at the 2018 ASCO Quality Care Symposium. “Incident learning systems are not just about medical errors or data; it’s kind of a first...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

Alan D. D’Andrea, MD, and Neal S. Young, MD, to Present 2018 ASH Ernest Beutler Lecture

THE AMERICAN SOCIETY of Hematology (ASH) will honor Alan D. D’Andrea, MD, of Harvard Medical School and Dana-Farber Cancer Institute, and Neal S. Young, MD, of the National Heart, Lung, and Blood Institute of the National Institutes of Health, with the 2018 Ernest Beutler Lecture and Prize for...

WHO Announces New Global Childhood Cancer Initiative

THE AMERICAN Childhood Cancer Organization (ACCO) supported the World Health Organization’s (WHO) announcement of a new global initiative to address the disparity between childhood cancer survival in low-middle versus high-income countries. The announcement came at the United Nations General...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

issues in oncology
lung cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

bladder cancer
immunotherapy

Expert Point of View: Shahrokh Shariat, MD

“BACILLUS CALMETTE-GUÉRIN (BCG) failures are quite common, with a 66% recurrence rate at 5 years, and about 25% of patients will have disease progression,” explained formal discussant Shahrokh Shariat, MD, Chair of the Department of Urology at Medical University, Vienna, and Adjunct Professor at...

bladder cancer
immunotherapy

Pembrolizumab Shows Antitumor Activity in Non–Muscle Invasive Bladder Cancer

THE ANTI–PROGRAMMED cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab (Keytruda) was found to have antitumor activity in patients with high-risk non–muscle invasive bladder cancer who were nonresponsive to bacillus Calmette-Guérin (BCG), according to the preliminary results of the ...

prostate cancer

Expert Point of View: Robert Bristow, MD, PhD; Ignacio Duran, MD; Karim Fizazi, MD

FORMAL DISCUSSANT Robert G. Bristow, MD, PhD, of the Manchester Cancer Research Centre, Manchester, United Kingdom, called this trial “an exemplar.” “Radiation to the prostate should be considered standard of care in the setting of hormone-sensitive low-metastatic burden. The treatment is well...

prostate cancer

Radiation to Primary Tumor Improves Survival in Subset of Men With Metastatic Prostate Cancer

MEN WITH newly diagnosed metastatic prostate cancer do not typically receive treatment to the primary tumor with radiation or surgery. A new analysis of the STAMPEDE trial found that radiation administered to the prostate can improve overall survival in men with newly diagnosed metastatic prostate...

gynecologic cancers

Expert Point of View: Jonathan Ledermann, MD, and Clara MacKay

“A KEY AIM of treatment is the need to focus on preventing recurrence, which happens in 70% of patients. Over the past 20 years, we have made few inroads in preventing recurrence. This study brings a poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) to the first-line setting,...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

lung cancer

Expert Point of View: Fiona Blackhall, MD, PhD

FORMAL STUDY discussant, Fiona Blackhall, MD, PhD, of the University of Manchester, UK, welcomed brigatinib (Alunbrig) as a new first-line option for ALK-positive patients but said, “In the absence of comparisons of next-generation ALK inhibitors, it will take some time to determine if there is...

lung cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

breast cancer
immunotherapy

Expert Point of View: Giuseppe Curigliano, MD, PhD

“IMPASSION130 IS a positive study of immuno-oncology that brings breast cancer into the immunotherapy era,” said the invited discussant of the trial, Giuseppe Curigliano, MD, PhD, Associate Professor of Oncology at the University of Milan and Chair of Early Drug Development at the Institute of...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

Final Analysis of SWOG POEMS: Goserelin and Chemotherapy in Breast Cancer

Final results of SWOG Cancer Research Network’s international Prevention of Early Menopause Study (POEMS) showed continued evidence that women who get injections of the hormone drug goserelin along with standard breast cancer chemotherapy are more likely to become pregnant, without developing ...

Trifluridine/Tipiracil in Heavily Pretreated Metastatic Gastric Cancer

In the phase III TAGS trial reported in The Lancet Oncology, Shitara et al found that trifluridine/tipiracil (Lonsurf) significantly improved overall survival vs placebo in patients with heavily pretreated metastatic gastric cancer. In the double-blind trial, 507 patients with nonresectable...

Surveillance Imaging Modality and Survival After Recurrence in Favorable-Histology Wilms Tumor

Findings in a study reported by Mullen and colleagues for the Children’s Oncology Group in the Journal of Clinical Oncology suggest that routine computed tomography (CT) surveillance may not be necessary for recurrence detection in favorable-histology Wilms tumor. The study was a...

Increased Survival in Patients With Metastatic NSCLC Receiving Treatment in Academic vs Community Centers

Patients with metastatic non­–small cell lung cancer (NSCLC) receiving treatment at academic centers have an increased 2-year survival compared to patients treated at community-based centers, according to findings published by Ramalingam et al in the Journal of Thoracic Oncology. An...

Progression-Free Survival and Health-Related Quality of Life in Randomized Clinical Trials

A review and analysis of randomized clinical trials published by Kovic et al in JAMA Internal Medicine questioned whether interventions that prolong progression-free survival (PFS) in patients with cancer improve their health-related quality of life (HRQoL). The systematic review and quantitative...

Five-Year Risk of Cervical Precancer With p16/Ki67 Dual-Stain or Cytology Triage in HPV-Positive Women

In a study reported in JAMA Oncology, Clarke et al found that triage with p16/Ki-67 dual-stain testing (DS) was associated with better risk stratification for cervical precancer than Papanicolaou cytology testing over 5 years among human papilloma virus (HPV)–positive women. Study Details...

Activity of Vemurafenib in BRAF V600–Mutant Gliomas

In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype.   Study Details In the study, 24...

Incidental Germline Mutations in Patients With Advanced Solid Tumors Identified by Cell-Free Circulating Tumor DNA Testing

In a study reported in the Journal of Clinical Oncology, Slavin et al determined the prevalence of a set of germline cancer predisposition gene mutations incidentally identified by cell-free circulating tumor DNA (cfDNA) testing in patients with advanced solid tumors. Study Details The study...

Combining Genetic and Sun Exposure Data May Improve Prediction of Skin Cancer Risk

By combining data on individuals’ lifetime sun exposure and their genetics, researchers may be able to generate improved predictions of their risk of skin cancer, according to findings presented by Fontanillas et al at the 2018 American Society of Human Genetics Annual Meeting (Abstract PgmNr ...

lymphoma
immunotherapy

Combination of Macrophage Immune Checkpoint Inhibitor and Rituximab in Non-Hodgkin Lymphoma

In a phase Ib study reported in The New England Journal of Medicine, Advani et al found that the combination of rituximab (Rituxan) and the CD47-blocking monoclonal antibody Hu5F9-G4 (or 5F9), a macrophage immune checkpoint inhibitor, was active in patients with non-Hodgkin lymphoma. CD47, which is ...

Pre- and Postdiagnosis Diet and Risk of Mortality in Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Guinter et al found that better prediagnosis and postdiagnosis dietary patterns were associated with improved overall and colorectal cancer­–specific survival among patients diagnosed with colorectal cancer. Study Details The...

FDA Approves Elotuzumab Plus Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On November 6, the U.S. Food and Drug Administration (FDA) approved elotuzumab (Empliciti) injection for intravenous use in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies,...

bladder cancer
immunotherapy

PURE-01 Trial: Neoadjuvant Immunotherapy in Muscle-Invasive Bladder Carcinoma

In the Italian phase II PURE-01 trial reported in the Journal of Clinical Oncology, Necchi et al found that neoadjuvant pembrolizumab (Keytruda) before radical cystectomy in muscle-invasive bladder carcinoma produced complete pathologic response (pT0) in 42% of patients, with pT0 being more common...

lung cancer

IASLC Issues Statement on Lung Cancer Screening With Low-Dose Computed Tomography

The International Association for the Study of Lung Cancer (IASLC) recently issued a statement on lung cancer screening with low-dose computed tomography (CT) based on the results of the Dutch-Belgian NELSON lung cancer screening trial presented at the IASLC 19th World Conference on Lung Cancer...

Samuel Waxman, MD, Receives China’s ‘Friendship Award’

The Samuel Waxman Cancer Research Foundation (SWCRF), an international nonprofit organization that funds cancer research, recently announced that its founder and Chief Executive Officer, Samuel Waxman, MD, has received China’s highest honor granted to a foreigner. The Vice-Premier of the People’s...

prostate cancer

AR-V7 as Marker for Taxane Therapy in Castration-Resistant Prostate Cancer

In a study reported in JAMA Oncology, Howard I. Scher, MD, of the Genitourinary Oncology Service, Memorial Sloan Kettering Cancer, and colleagues found that the presence of nuclear-localized androgen receptor splice variant 7 (AR-V7) protein in circulating tumor cells may predict better survival...

prostate cancer

Robot-Assisted Laparoscopic Prostatectomy in Newly Diagnosed Prostate Cancer

In an Australian phase III trial reported in The Lancet Oncology, Suzanne K. Chambers, PhD, of the Menzies Health Institute Queensland, Griffith University, Gold Coast, and colleagues found similar functional outcomes at 2 years with robot-assisted laparoscopic prostatectomy and open radical...

prostate cancer

Early PSA Testing Could Help Predict Prostate Cancer Among Black Men

In a study published by Mark A. Preston, MD, MPH, and colleagues in European Urology, researchers demonstrated that a baseline prostate-specific antigen (PSA) level obtained from black men between 40 and 60 years old may predict the future development of prostate cancer for years after testing....

Thomas J. Dougherty, PhD, Father of Photodynamic Therapy, Dies at Age 85

Thomas J. Dougherty, PhD, the developer of modern photodynamic therapy and Chief Emeritus of Roswell Park’s Photodynamic Therapy Center, died October 2, 2018, in Buffalo, New York. “He was undoubtedly the major influence in bringing [photodynamic therapy] into the realm of cancer therapy,” said...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

Living a Full Life After a Diagnosis of Cancer

BOOKMARK Title: Here We Grow: Mindfulness Through Cancer and BeyondAuthor: Paige DavisPublisher: She Writes PressDate: May 2018Price: $22.95, paperback, 154 pages Since the publication of Dr. Paul Kalanithi’s best-selling book, When Breath Becomes Air, about his diagnosis of cancer and untimely...

NCCN Relocates Global Headquarters

The National Comprehensive Cancer Network® (NCCN) has moved into new headquarters to Plymouth Meeting, Pennsylvania, near Philadelphia. The new location will allow for greater hosting capacity for meetings, guests, and a growing staff. “International surveys repeatedly show that oncologists...

FDA Releases Draft Guidance for Clinical Trial Design

The U.S. Food and Drug Administration (FDA) announced the availability of the Draft Guidance Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Cancer Drugs and Biologics. Master protocol trial designs are complex due to the concurrent evaluation of multiple...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

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