Expert’s Corner
Early Research on Novel Interleukin-12 ‘Gene Therapy’ in Glioblastoma
Caroline Helwick
Recurrent high-grade glioblastoma has a poor prognosis, with a median overall survival of 6 to 9 months. Treatment is limited, partly because immunotherapy has not yet been shown to be effective in the immunosuppressive microenvironment of this tumor. A novel treatment approach involving drug-induci...
Managing Rectal Cancer: Better Outcomes Now, but Still a Challenging Clinical Setting
Ronald Piana
The management of rectal cancer has evolved over the past decades, yielding several major practice changes that have substantially improved outcomes. However, rectal cancer treatment remains challenging and even with improved outcomes can result in life-altering morbidity. To shed light on the curre...
Inequities in Care for Patients With Cancer and Serious Mental Illness
Ronald Piana
Studies show that people suffering from serious mental illness are at increased risk for poor cancer outcomes and mortality due to inequities in their cancer care. Although psychiatric care at the time of diagnosis may improve care, current models for integrating psychiatric interventions and cancer...
Researchers Examine the Rise in HPV-Related Oropharyngeal Cancers
Ronald Piana
Human papillomavirus (HPV) causes nearly all cervical cancers and is attributed to some cancers of the vagina, vulva, penis, anus, and oropharynx. Although most HPV infections are asymptomatic and usually resolve within 1 to 2 years, persistent infections can lead to precancer and cancer. According ...
How Ultrahigh-Dose Radiation Therapy, Interferon, and CAR T Cells May Boost Immunotherapy Effectiveness
Jo Cavallo
This past June, the University of Pennsylvania established the Mark Foundation Center for Immunotherapy, Immune Signaling, and Radiation to study the role interferon and pattern recognition receptor signaling transduction pathways play in modulating the immune system’s ability to recognize and destr...
Investigating the Inflammatory Mechanisms That May Be Causing Prostate Cancer in World Trade Center First Responders
Jo Cavallo
The terrorist attacks on September 11, 2001*, on the World Trade Center in New York City resulted in the deaths of more than 2,700 people.1 Nearly 2 decades later, that number may soon be exceeded by the more than 2,000 deaths—and climbing—of first responders to the attack, including firefighters, p...
The Role of Primary Care Physicians in Cancer Care
Ronald Piana
As our aging population increases, so does the demand for oncology services; however, as ASCO and other organizations have pointed out, a workforce shortage of oncology care specialists looms in the not-so-distant future. Given the growing need for care models that meet this demand, a better underst...
Oncology Communications Online: Pause and Think Before Hitting ‘Send’
Ronald Piana
The emergence of online technologies over the past few decades has fundamentally changed the way society communicates and shares information. This sea change has also had profound influence on the practice of medicine, from real-time information-sharing among colleagues, to having instant access t...
How Patient Advocacy Is Integral to High-Quality Oncology Care
Jo Cavallo
Karen M. Winkfield, MD, PhD, has made patient advocacy—with a specific emphasis on health equity and access to high-quality care—front and center of her oncology practice since she completed her residency at the Harvard Radiation Oncology Program in Boston, where she noticed that most of the patie...
Primary Central Nervous System Lymphoma: Striving for a Curative Therapy
Caroline Helwick
Primary central nervous system (CNS) lymphoma is a rare type of non-Hodgkin lymphoma in which standards of care have not been well established. In light of recent insights into its pathophysiology and the emergence of novel approaches, The ASCO Post asked Tracy T. Batchelor, MD, a specialist in prim...
Confronting the Criticisms Facing Watson for Oncology
Jo Cavallo
Over the past 2 years, IBM’s Watson for Oncology cognitive computing system, which uses artificial intelligence (AI) algorithms to generate treatment recommendations, has come under fire for allegedly not delivering on expectations to provide state-of-the-art personalized treatment for patients with...
Looking at Prostate Cancer–Specific Mortality by Gleason Score and Race
Ronald Piana
Black men suffer disproportionately from prostate cancer, both in terms of incidence and mortality, compared with their white counterparts. However, a newer study conducted by investigators at the University of California, San Francisco, and Dana-Farber Cancer Institute, Boston, found that black men...
The Role of Primary Care Physicians in Pediatric Cancer Survivorship
Ronald Piana
The symptoms related to childhood cancers that first prompt parents to seek medical care may be as nonspecific as those of the flu or a number of other common ailments. Therefore, a suspicion of cancer sometimes emerges during a visit to the child’s primary care physician. Although primary care phys...
Eighth Edition of the AJCC Staging Manual Offers a More Personalized Approach to Patient Classification
This year marks the 60th anniversary of the creation of the American Joint Committee on Cancer (AJCC), whose founding mission was to standardize the anatomic staging of cancer based on the size of a tumor and any spread to nearby tissue (T); the spread of the cancer to nearby lymph nodes (N); and th...
How Technology Is Transforming the Assessment of Inherited Cancer Risk
ASCO published its first statement on genetic testing and its impact on oncology practice over 2 decades ago. Since then, ASCO has revised the statement three times, the most recent in 2015, in response to advances propelled by the sequencing and mapping of the human genome and the identification of...
How the ASCO Breakthrough Global Summit Is Bringing Together Innovators to Transform Cancer Care
Earlier this year, ASCO announced plans for its first-ever international meeting, ASCO Breakthrough: A Global Summit for Oncology Innovators, which will be held October 11–13, 2019, in Bangkok, Thailand. The meeting is a joint effort by ASCO and the Thai Society of Clinical Oncology to bring togethe...
Is It Time to Reevaluate the P Value in Biomedical Research?
Developed in 1925 by British statistician Sir Ronald Fisher, the P value is a measure that is ever-present in abstracts and studies, a small statistical tool that has enormous power to aid research being published in the literature or support drug approval. Over the past several years, however, a gr...
Looking Into the Future of Psychosocial Oncology
Over the past several decades, the field of psychosocial oncology has matured into an invaluable subspecialty that helps patients with cancer and their caregivers deal with the existential issues that arise in cancer, especially in the advanced-disease setting. In an effort to add to this importan...
Emerging Interest in Metabolic Pathways to Tumorigenesis
Although genetic aberrations are considered a major reason for cancer development, the importance of metabolic alterations in cancer development has emerged as a crucial aspect of contemporary cancer research. Better understanding of the metabolic traits in cancer cells could aid researchers in ...
Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer
Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged...
How Immunologic Dysregulation in the Multiple Myeloma Microenvironment May Affect Response to CAR T-Cell Therapy
Despite an avalanche of novel therapies approved by the U.S. Food and Drug Administration (FDA) over the past decade in the treatment of multiple myeloma, including proteasome inhibitors and immunomodulatory drugs, this blood cancer remains largely incurable, and nearly 13,000 people are expected to...
Incoming ASCO President Sets His Sights on Conquering Cancer
For more than 3 decades, Howard A. “Skip” Burris III, MD, FACP, FASCO, has dedicated his medical career to researching the development of chemotherapies for breast cancer, including ado-trastuzumab emtansine, everolimus, and gemcitabine. In addition, he is credited with changing the standard of care...
Introducing CancerLinQ® 2.0 and a New Era in Precision Oncology
In just 5 years since its launch in 2014, CancerLinQ®, ASCO’s big-data, rapid-learning, health information technology platform, has grown from 37 vanguard oncology practices to 58 participating practices in 2016 to 100 diverse oncology practices nationwide this year. CancerLinQ (https://cancerlinq.o...
Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL
Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved t...
New Radiation Options for Localized Prostate Cancer May Improve Patient Outcomes
External-beam radiation therapy (EBRT) is a standard treatment option for men with localized prostate cancer and confers long-term prostate cancer control outcomes equal to radical prostatectomy. Technologic advances in imaging and computing during the past 20 years have led to a number of innovatio...
St. Jude Children’s Research Hospital and WHO Join Forces to Improve Childhood Cancer Survival Worldwide
A report by the International Agency for Research on Cancer (IARC) based on data from more than 100 cancer registries in 68 countries shows that from 2001 to 2010, the occurrence of childhood cancer worldwide was 13% more common than in the 1980s.1 In addition, the report’s findings showcase stark d...
Uniting the Global Cancer Community to Reduce Deaths From Noncommunicable Diseases
It has been well documented that noncommunicable diseases, including cancer, cardiovascular disease, and diabetes, now pose the greatest health threat to people living in low- and middle-income countries, surpassing infectious diseases like HIV/AIDS as the leading cause of death and disability.1 Mor...
Measuring the Burden of Global Cancer as a Tool for Policymakers
The Global Burden of Disease Study was initiated in 1990, commissioned by the World Bank. At that time, the study was conducted mainly by researchers at Harvard and the World Health Organization (WHO). Since then the study has gone through many iterations to its present structure, which is a collabo...
Debating the Role of Opioids in the Management of Chronic Cancer Pain
Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving opioids,...
New ASCO Guidelines on Early Detection and Treatment of Colorectal Cancer in Resource-Stratified Settings
Jasenka Piljac Žegarac, PhD
ASCO has approved two new resource-stratified guidelines aimed at improving the early detection and treatment of colorectal cancer in all resource settings. The guidelines are a continuation of ASCO’s efforts to provide evidence-based recommendations for the management of malignancies applicable...
The Evolving Role of Pathologists in the Diagnosis and Treatment of Cancer
In the past, the role of the pathologist was primarily to present anatomic pathology findings on various specimens, particularly at tumor boards. However, in the emerging age of personalized medicine and molecular diagnostics, the responsibilities of pathologist have greatly expanded into cancer-rel...
Human Gene Therapy: Progress and Oversight
The early debate over the social and ethical implications of gene therapy led the National Institutes of Health (NIH) to establish the Recombinant DNA Advisory Committee in 1974. However, the risks of human gene therapies were largely unknown until 1999, when a patient died of a massive immune res...
Assessing the Clinical Utility of ASCO’s and ESMO’s Value Frameworks
In 2015, ASCO and the European Society for Medical Oncology (ESMO) introduced value frameworks that utilize algorithmic scales to evaluate the clinical benefit of cancer therapies and provide an objective assessment of outcomes and treatment toxicities experienced by patients.1,2 Although the two fr...
Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low
The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results, population-bas...
Artificial Intelligence and the Brave New World of Cancer Diagnostics
Ronald Piana
A study published in Nature Medicine found that an artificial intelligence program could distinguish between the histologic diagnosis of adenocarcinoma and squamous cell carcinoma.1 Experienced pathologists often struggle to differentiate these tumor types without confirmatory tests. The artificial ...
How Turning ‘Cold’ Tumors Into ‘Hot’ Ones May Improve Response to Immunotherapy
Jo Cavallo
The proliferation of immunotherapeutics in the treatment of cancer over the past decade has revolutionized the way many cancers are treated, especially lung cancer and melanoma, as well as some blood cancers, including leukemia and lymphoma, drastically improving outcomes for many patients with thes...
Hastening the Development of Novel Therapies for Peripheral T-Cell Lymphomas
Peripheral T-cell lymphomas (PTCLs) make up a small fraction of all non-Hodgkin lymphomas—just 15%—in the United States.1 Although rare in the United States, the incidence of PTCL is common across Asia, the Caribbean, and sub-Saharan Africa. Although the reason for such global variation in PTCL is n...
Update on Immune Checkpoint Inhibitors
Ronald Piana
Checkpoint inhibitors have moved the field of immuno-oncology to the forefront of cancer treatment and research. However, these agents come with the risk of serious adverse events. To shed light on the toxicities associated with checkpoint inhibitors and other timely issues in the field of immunot...
Overscreening for Prostate Cancer in Older Men Remains an Issue
Ronald Piana
Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the Univ...
Palliative Care in the Pediatric Oncology Setting
Ronald Piana
Cancer is the leading cause of disease-related childhood death. To better serve the special needs of this highly vulnerable patient population, pediatric palliative care teams use a personalized, holistic, and interdisciplinary approach tailored to relieve the physical, psychosocial, and spiritual...
Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance
Ronald Piana
In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S. P...
Inflammation, DNA Damage, and Cancer
Ronald Piana
The link between inflammation and cancer is a field of growing interest in the oncology community. Biologists have theorized that simultaneous DNA damage and cell division during inflammation could lead to cancer. To shed light on this important issue, The ASCO Post recently spoke with Jennifer Ka...
Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer
Ronald Piana
In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and th...
Patients With Cancer in Rural America Remain Underserved
Ronald Piana
Despite growing national awareness of health-care inequities, the plight of rural Americans diagnosed with cancer has persistently remained inadequate. Speaking with The ASCO Post, Jan Probst, PhD, Professor at the Arnold School of Public Health, University of South Carolina, Columbia, noted, “We ...
The Abscopal Effect: A Reemerging Field of Interest
Ronald Piana
For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements i...
How the Nobel Prize Could Spur More Cancer Advances
Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto Uni...
Big Data and Breast Cancer: Moving the Field Forward Through Comprehensive Analysis
Ronald Piana
To gain further insight into, among other things, optimizing big data and the latest on hormonal breast cancer treatment, The ASCO Post recently spoke with pioneering oncologist Christopher C. Benz, MD, a breast cancer specialist and Director of the Cancer & Developmental Therapeutic...
New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer
Ronald Piana
Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the possi...
CAR T-Cell Therapy for CLL
Jo Cavallo
A pair of new studies from researchers at the Abramson Cancer Center of the University of Pennsylvania are shedding light on why patients with advanced chronic lymphocytic leukemia (CLL) respond or do not respond to chimeric antigen receptor (CAR) T-cell therapy. Although CAR T-cell therapy is showi...
Understanding the Different Perspectives on Cost and Value in Cancer Care
Ronald Piana
The estimated cost of cancer care in the United States was $125 billion in 2010 and is expected to rise to $175 billion by 2020.1 In an effort to reign in spiraling costs and deliver better care, the term “value” has become part of the new oncology lexicon, as providers, patients, and payers seek ...
Male Breast Cancer: An Understudied Malignancy
Ronald Piana
Male breast cancer is a rare and understudied malignancy when compared with female breast cancer, with conflicting literature on survival outcomes in men and women. The ASCO Post spoke recently with breast cancer expert Sharon Giordano, MD, MPH, FASCO, Professor at The University of Texas MD Ander...
Bringing Together Industry, Academia, and Nonprofits to Advance Breast Cancer Research
Jo Cavallo
In 2016, the Breast Cancer Research Foundation (BCRF) launched the Drug Research Collaborative, a program the foundation developed to bridge the gap between academic investigators and their access to therapies under investigation and to encourage greater academia-driven research in breast cancer. Th...
Unraveling the Mystery of What Gives Exceptional Responders Their Superpower
Once dismissed as rare medical miracles that overcame overwhelming odds to thwart cancer, exceptional responders to cancer treatment are now the subject of intense study. In 2015, the National Cancer Institute (NCI) announced the launch of its Exceptional Responders Initiative, with the goal of un...
Obesity and Cancer: Complex Interplay of Multiple Factors
Ronald Piana
The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...
Psycho-oncology: After Decades of Acceptance, Still an Emerging Field
Ronald Piana
As the field of psycho-oncology continues to mature, new studies are being conducted to evaluate ways to better address the needs of patients with cancer and their families. The ASCO Post recently spoke with Michael Hoerger, PhD, MSCR, Assistant Professor of Psychology, Psychiatry, and Oncology at...
Oncofertility: An Emerging and Much-Needed Field
Ronald Piana
The American Cancer Society estimated that in 2015 in the United States, more than 86,000 women younger than age 45 were diagnosed with cancer. Many of them face reproduction and fertility concerns, which could lead to long-term distress and impaired quality of life in survivorship. To shed light ...
Medical Preparedness for Nuclear Disaster
Ronald Piana
ROBERT PETER GALE, MD, PhD, DSc (hc), was on the faculty of the University of California, Los Angeles, School of Medicine for 20 years and has served as Chairman of the Scientific Advisory Committee of the Center for International Blood and Marrow Transplant Research. In 1986, he was asked by the ...
Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records
Ronald Piana
Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities ass...
Is Universal Health Care a Human Right?
Ronald Piana
The Affordable Care Act (ACA) provided oncology services to people with cancer who had previously been denied coverage. And for that reason alone, many oncologists supported its passage. However, even though the U.S. health-care system remains in the crosshairs of partisan politics, parties on both ...
Is the Move to a Value-Based Health-Care Delivery System Feasible?
In 2015, Congress passed the Medicare Access and CHIP Reauthorization ACT (MACRA), which aims to move Medicare toward reimbursement based more on outcomes and values, a goal, in theory, shared by the oncology community. To shed light on the complicated and problematic attempt to restructure the pa...
Ensuring High-Quality Oncology Care for Patients With Intellectual Disabilities
Despite significant gains in improved access to public places, transportation, and job opportunities for people with disabilities since the enactment of the Americans With Disabilities Act in 1990, the long history of discrimination in the social and medical treatment of people with disabilities is ...
Minimal Residual Disease Testing in AML: Still a Shifting Target
Caroline Helwick
Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently...
Optimizing Biologics in Metastatic Colon Cancer
Caroline Helwick
Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1 wi...
Hematopoietic Cell Transplantation for Follicular Lymphoma
Caroline Helwick
Many patients with follicular lymphoma relapse within 2 years of initial therapy, and for a number of these individuals, hematopoietic cell transplantation is a good treatment option. Transplant, however, both autologous and allogeneic, is vastly underutilized in these patients, according to Mehdi...
Minimal Residual Disease in Acute Myeloid Leukemia: Mutation Matters
Caroline Helwick
A RECENT article in The New England Journal of Medicine explored the nuances of minimal/measurable residual disease testing after induction treatment of acute myeloid leukemia (AML)1 and David P. Steensma, MD, and Benjamin L. Ebert, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical School...
Now More Than Ever, the Oncology Pharmacist Can Play a Variety of Roles on the Health-Care Team
A. Kate Macdougall
Susannah E. Koontz, PharmD, BCOP, FHOPA, is a consultant for clinical pharmacy services, research, and education in the areas of pediatric hematology/oncology, stem cell transplantation, and cellular therapy. She has held positions at the Children’s Cancer Hospital at The University of Texas MD An...
New Laws Reduce Costs of Oral Cancer Drugs, but Not for All
The rising cost of anticancer drugs not only adds fiscal pressure to our overburdened health-care system, but also increases the stress on patients with cancer and their families. High out-of-pocket spending may cause significant financial toxicity, even for patients with good health insurance cov...
A Clinician’s Guide to Treating Patients With Glioblastoma
Caroline Helwick
Glioblastoma, a grade 4 astrocytoma, is the most common and most aggressive form of primary brain tumors in adults. The most recent guidance on molecular profiling, diagnostic and prognostic factors, and treatments for newly diagnosed and recurrent diseases was described in the Journal of Oncology...
Is CAR T-Cell Therapy Setting a New Standard of Care in Lymphoma?
Data presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition on the longer-term follow-up analysis of results from the ZUMA-1 trial investigating the effectiveness of axicabtagene ciloleucel (Yescarta) in patients with refractory non-Hodgkin lymphoma (NHL) showed i...
Solid Organ Transplantation and Lymphoma
Caroline Helwick
Survival of patients with Hodgkin and non-Hodgkin lymphomas is increasing, and with that comes the need, in some cases, for solid organ transplantation, often because of treatment-related toxicity. The factors involved in organ transplant among lymphoma survivors were discussed by Philip J. Bierma...
Advancing Cancer Research in Challenging Times
ON OCTOBER 17, 2017, Norman E. Sharpless, MD, became the 15th Director of the National Cancer Institute (NCI), succeeding Harold E. Varmus, MD, who stepped down as Director of the agency in March 2015, and replacing Douglas R. Lowy, MD, who had served as Acting Director for 2 years. The appointmen...
Making Personalized Medicine a Reality for More Patients With Cancer
Jo Cavallo
This past September, Olivier Elemento, PhD, Associate Director of the Institute for Computational Biomedicine and Director of the Laboratory of Cancer Systems Biology at Weill Cornell Medicine in New York, was named Director of Weill Cornell’s Englander Institute for Precision Medicine. In this p...
Lung Cancer in Never Smokers: A Complex Clinical Phenomenon
Ronald Piana
Despite advances in prevention, early detection, and treatments, lung cancer remains the leading cause of cancer-related death in the United States. Although cigarette smoking is the main cause of lung cancer, about 10% of these patients are lifelong never smokers for whom the molecular compositio...
Helping Patients With Head and Neck Cancer and Their Caregivers Face Treatment-Associated Challenges
Ronald Piana
Head and neck cancer remains one of the most challenging clinical presentations faced by the oncology community. Patients must not only face a potentially lethal disease, but must also cope with treatments that often result in significant side effects. To gain a better understanding on the treatment...
Is Medical Assistance in Dying Compassionate Care?
Ronald Piana
Suicidal ideation while receiving end-of-life cancer care is not unusual but can often be reversed by palliative and psychosocial oncology interventions. That said, there are patients who, even after intensive interventions, request medical assistance in dying. Physician-assisted death has been a ho...
How ASCO’s New Initiatives Are Helping Oncologists Transition to MACRA
Jo Cavallo
This year has been an important transitional period for oncology providers to start collecting their performance data to meet the requirements of the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program is a pay-for-perfo...
Future Directions for CAR T-Cell Therapy
Alice Goodman
Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration (FDA...
Helping Oncologists to Become Better Communicators With Their Patients
Jo Cavallo
Timothy Gilligan, MD, FASCO, Co-Chair of ASCO’s Expert Panel on Patient-Physician Communications Guideline and Vice-Chair for Education and Associate Professor of Medicine at the Cleveland Clinic Taussig Cancer Institute, spends half of his professional time treating patients with urologic maligna...
A Pioneer in Bloodless Transplant Discusses Advances in Blood Management
Ronald Piana
Bloodless stem cell transplantation, performed without the transfusion of allogeneic blood or blood products, has numerous clinical advantages, especially among populations of patients who prefer, for religious or other reasons, no blood methods of medical and surgical treatment. Patricia A. Ford,...
Could the Rising Rates of Colorectal Cancer in AYAs Be Linked to HPV Infection?
TWO STUDIES published this year examining the incidence of colorectal cancer in adolescents and young adults (AYAs) show an undeniable and sobering trend: Colorectal cancer rates are increasing in this age group, and younger people are dying of the cancer at slightly higher rates than in previous ...
Cord Blood Transplantation Proves Beneficial in High-Risk Patients With Leukemia
Studies show that only about one-third of patients with acute myeloid leukemia who have detectable amounts of cancer cells in their blood at the time of allogeneic hematopoietic cell transplantation will be alive 3 years later, compared with nearly three-quarters of those patients without minimal ...
Treating Breast Cancer During Pregnancy Calls for Careful Timing of Therapies and Sensitive Discussions With Patients
Ronald Piana
Breast cancer during pregnancy is relatively uncommon; however, it poses a significant clinical challenge to the patient and her multidisciplinary care team. To shed light on this difficult issue, The ASCO Post spoke with Carey K. Anders, MD, a medical oncologist and researcher at the University o...
Increasing Racial and Ethnic Diversity in the Oncology Workforce
Although significant progress has been made in cancer incidence and mortality in the United States over the past 2 decades—the death rate fell 23% between 1991 and 20121—not everyone is benefiting equally. According to the American Cancer Society, blacks have the highest death rate and shortest surv...
Balancing Harms and Benefits of Cancer Screening: The Debate Continues
Ronald Piana
Over the past several decades, widespread cancer screening has saved lives from various cancer types. However, despite advances in early-detection technologies, many cancers still remain undetected until they become symptomatic, conferring poor prognoses and outcomes. Moreover, some methods of scr...
Overdiagnosis of Those in Higher Income Brackets
Ronald Piana
According to researchers from the Dartmouth Institute for Health Policy and Clinical Practice, being in a high-income bracket may lead to overdiagnosis of cancer and the subsequent harms associated with unnecessary medical treatments. To shed light on this interesting finding and its broader implica...
Testing Alpha-Emitting Radiolabeled Immunotherapy to Treat—and Potentially Cure—Multiple Myeloma
Jo Cavallo
Despite a flurry of treatment advances in multiple myeloma over the past decade that have increased overall survival from just 2 to 3 years in the 1990s to between 5 and 7 years today—with some data suggesting an extended life expectancy of between 7 and 10 years1—the cancer remains stubbornly incur...
Addressing the Societal Impact of Financial Toxicity
Ronald Piana
Most discussions about “financial toxicity” center on the cancer patient, but there is also a societal toxicity, which has far-reaching consequences. Coming up with answers to this growing problem has vexed health-care experts over the past decade. In an effort to gather opinions on this...
The Rising Incidence of Thyroid Cancer Reconsidered
Ronald Piana
Despite a significant rise in the incidence of thyroid cancer, the U.S. Preventive Services Task Force (USPSTF), a panel of independent experts in primary care and screening, has given thyroid cancer screening a D recommendation, which is a recommendation against screening. To shed light...
Triple-Negative Breast Cancer: Practical Approach, Promising Research
Caroline Helwick
Triple-negative breast cancer has a reputation for being a particularly challenging malignancy, but breast cancer specialist Nancy Davidson, MD, Senior Vice President of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle, put this in perspective in a recent artic...
Unraveling the Complexities of Cellular Immunotherapy and Its Potential to Cure Some Cancers
This past fall, the Fred Hutchinson Cancer Research Center in Seattle opened an all-encompassing 9,222-square foot outpatient cellular immunotherapy clinic, specifically designed to serve patients participating in the center’s novel immunotherapy clinical trials, which mainly focus on chimeric antig...
FDA’s First Site-Agnostic Drug Approval Marks a Paradigm Shift in Regulatory Criteria
IN MAY, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with solid tumors that have the microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) biomarker, which disrupts the ability of cells to repair DNA. The ap...
An Educational Program for Safe Handling of Opioids
Ronald Piana
Improper storage, use, and disposal of prescribed opioids can lead to diversion or accidental overdose. Given that opioids are the mainstay of cancer pain treatment, this issue is particularly germane in the oncology community. The ASCO Post recently spoke with Akhila Reddy, MD, and Maxine de la...
The Immune System: Deciphering Recent Advances
Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the cellu...
Stereotactic Body Radiotherapy for Poor Performance Status Patients With Pancreatic Cancer
Caroline Helwick
There are few data to guide the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have a poor performance status. Although most such patients are offered supportive care or gemcitabine alone, the addition of stereotactic body radiotherapy may improve outco...
Pediatric Cancer Pain May Be Misunderstood and Largely Undertreated
Cancer pain in children poses certain unique challenges. Over the past decade, insightful research into pediatric cancer pain has focused on pain management that incorporates nonopioid therapies into standard care. To shed light on this important issue, The ASCO Post spoke with Christine T. Chambers...
Strides Being Made in Advanced Urothelial Cancer
Caroline Helwick
According to Srikala S. Sridhar, MD, MSc, FRCPC, of the Princess Margaret Cancer Centre, Toronto, Canada, “It’s an exciting time in the field of urothelial cancer,” thanks to the emergence of new therapies such as the immune checkpoint inhibitors and other approaches that aim to improve both outco...
Growing Use of Molecular Pathology May Help Avoid Overtreatment of Early Breast Cancer
The emerging field of molecular pathology focuses on the study and diagnosis of disease through the examination of genes and gene activity within organs and tissues. This information has transformed our thinking about the biologic diversity of breast cancers and has enhanced our treatment decision...
Combinations of Novel Treatment Approaches Continue to Make Progress in Overcoming Challenges of Pediatric Brain Tumors
Nearly 2,500 children in the United States are diagnosed with brain tumors each year, making these malignancies among the most common solid tumors in children and adolescents. Despite advances over the past few decades, the treatment of brain tumors remains one of the most challenging clinical areas...
ASCO CEO Reflects on His First Year in Office and What Is Ahead
June 27, 2017, marks the 1-year anniversary since Clifford A. Hudis, MD, FACP, FASCO, began his tenure as Chief Executive Officer of ASCO. With the launch of the national Cancer Moonshot and the changes in the White House and Congress, it has been a year of tremendous activity drawing on...
Setting His Presidential Course on Making Precision Medicine a Reality for More Patients
Ensuring that all patients with cancer have access to the potential benefits of precision medicine regardless of where they are treated has been a primary goal of Bruce E. Johnson, MD, FASCO, since the concept was first introduced following completion of the Human Genome Project in 2003....
What Is Appropriate Treatment of Oligometastatic Hormone-Sensitive Prostate Cancer?
Caroline Helwick
As the subtleties of metastatic prostate cancer become increasingly recognized, treatment should evolve accordingly, said Jessica M. Clement, MD, Assistant Professor of Medicine at the University of Connecticut Health System and Neag Cancer Center, Farmington. Of particular interest to Dr. Clement...
Expanding Role Seen for Minimal Residual Disease in Managing Multiple Myeloma
Minimal residual disease is a promising biomarker for guiding the management of multiple myeloma that is becoming increasingly important with the advent of more efficacious therapies, according to emerging data and expert opinion. “The story of minimal residual disease in multiple myelo...
How ASCO’s CancerLinQ Discovery™ Will Help Speed Research Advances and Improve Patient Outcomes
This past November, ASCO announced the launch of CancerLinQ Discovery™, a big data learning platform physicians and researchers can use to analyze highly curated, de-identified, real-world cancer care data sets to broaden their clinical knowledge about specific cancers and eventually improve patient...
Treating Human Immunodeficiency Virus–Related Lymphoma
Alexandra Levine, MD, MACP, is Professor in the Department of Hematology and Hematopoietic Cell Transplantation at City of Hope, Duarte, California, and has been on the front lines of the AIDS epidemic from the beginning—before the disease even had a name. Dr. Levine spoke with The ASCO ...
Study Projects HIV-Related Cancer Burden to Decline
The ASCO Post
The total number of cancer cases diagnosed among people living with the human immunodeficiency virus (HIV) is projected to decline in coming years, due mostly to declines in non-Hodgkin lymphoma and Kaposi sarcoma. Certain other cancers, such as prostate and lung, are expected to rise, according to ...
Stage I Lung Cancer: Treatment Advances Have Changed the Game
Caroline Helwick
Read more in the Journal of Oncology Practice (JOP). Visit ASCOPubs.org/journal/jop Patients with stage I lung cancer are achieving excellent local tumor control, thanks to an evolution in radiotherapy and surgical approaches. Jeffrey A. Bogart, MD, Professor and Chair of the Department of Radiat...
Different Subtypes of Acute Myeloid Leukemia Create Both Clinical and Research Challenges
Acute myeloid leukemia (AML) is the most common leukemia in adults. Each year, about 20,000 Americans will be diagnosed with AML, and roughly 10,000 people in this country will die of the disease. AML progresses quickly, and unless treatment begins soon and is effective , the prognosis is grim. On...
Forging a New Role to Make Curing More Cancers a Reality
For more than 3 decades, Nancy E. Davidson, MD, has dedicated her clinical and research career to better understanding the molecular mechanisms driving the development of breast cancer and to the discovery of more effective therapies to treat the disease. The recipient of an ASCO Young I...
For One Hematologist, No Disease Progressions in Follicular Lymphoma With Rituximab Maintenance
Caroline Helwick
Patients with follicular lymphoma are clearly living longer without disease progression, but what clinician has had no patients progress? Michael Auerbach, MD, a hematologist/oncologist in private practice in Baltimore and Clinical Professor of Medicine at Georgetown University, may have...
Low-Grade Gliomas: Understanding the New Treatment Paradigm
Caroline Helwick
Diffuse infiltrating low-grade gliomas include oligodendrogliomas and astrocytomas and account for about 5% of all primary brain tumors. Treatment strategies for these low-grade gliomas in adults have recently changed, as detailed in a recent review in the Journal of Oncology Practice.1 ...
Combination Immunotherapy for Lung Cancer: The Wave of the Future
Susan London
Increasing experience with immunotherapy for lung cancer in both the lab and the clinic is helping to refine treatment approaches and point the way forward, according to Naiyer Rizvi, MD, Director of both Thoracic Oncology and Immunotherapeutics at Columbia University Medical Center in N...
Understanding Cancer Epigenetics and Its Clinical Implications
Ronald Piana
The field of epigenetics emerged in the 1990s and has been described with somewhat variable meanings. In 2008, a meeting at the Cold Spring Harbor laboratory arrived at a definition of epigenetics by consensus: “A stably heritable phenotype resulting from changes in a chromosome without ...
New President of the Skin Cancer Foundation Emphasizes Public Education to Reduce Skin Cancer Incidence and Deaths
The statistics on the rising rates of skin cancer are alarming. According to the Skin Cancer Foundation, each year over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people, and an additional 76,380 people are diagnosed with the deadliest form of skin ...
Telemedicine: Transforming Health Care One Computer at a Time
Ronald Piana
Telehealth is the delivery of health care remotely via telecommunication tools. Its aim is to increase access to care, especially for patients with chronic diseases such as cancer and for populations for whom care is not always available. With the growing availability of broadband and po...
How ASCO’s New Health Policy Fellowship Program Is Helping Shape Future Cancer Care Policy
In October 2015, ASCO launched the Health Policy Fellowship program to help the next generation of oncologists with an interest in health policy to develop the skills and experience necessary to achieve their goals and shape cancer care policy in an increasingly complicated and diverse care delivery...
Canadian Study Looks at an Integrated Palliative Care Model
Ronald Piana
Although initiation of palliative care from the time of cancer diagnosis produces optimal outcomes for patients, this strategy is often not practiced. A recent Canadian study conducted in patients with advanced cancer and their caregivers examined the opinions of patients with advanced c...
Accelerating Progress in the Treatment of Glioblastoma Multiforme
Jo Cavallo
W.K. Alfred Yung, MD, has wanted a career in medicine since he was a high-school student and has spent nearly 4 decades fulfilling that dream, specifically in the research and treatment of one of the deadliest cancers, malignant brain tumor, especially glioblastoma multiforme, the most common brai...
Treatment of Early HER2-Positive Breast Cancer: One Size Does Not Fit All
Caroline Helwick
Despite the routine use of HER2 blockade in early HER2-positive breast cancer, clinicians can always benefit from a refresher on key treatment considerations. Clinical pearls and controversial issues were the topic of a presentation at the 14th Annual School of Breast Oncology at Emory U...
Reducing the Risk of Oral Complications During and After Cancer Therapy
Jo Cavallo
According to the National Institutes of Health,1 nearly all patients with head and neck malignancies receiving high-dose radiation therapy; approximately 80% of patients undergoing stem cell transplantation; and about 40% of patients receiving chemotherapy will experience oral complications that may...
Peer-Reviewed Indian Journal of Surgical Oncology Meets Challenges, Succeeds in Developing Country
Ronald Piana
Launching a new cancer journal is a risky and arduous endeavor, especially for a specialty publication in resource-challenged countries in the developing world. To succeed, a specialty journal must publish articles from established clinical researchers that quickly garner funding and captivate its i...
Using Art to Humanize Medicine
Jo Cavallo
Among the most widely attended sessions at the 2016 Palliative Care in Oncology Symposium in September was the keynote lecture, “Wit, Hex, Vin, Life, Death: Using Wit as a Teaching Tool,” given by Margaret Edson, author of the Pulitzer Prize–winning play Wit. Wit tells the story of an accomplished...
Optimizing Allogeneic Stem Cell Transplantation in Myelofibrosis
Caroline Helwick
Allogeneic hematopoietic stem cell transplantation is the only potentially curative treatment for myelofibrosis. The ASCO Post asked an expert in this field, Ayalew Tefferi, MD, how and when he uses stem cell transplant in myelofibrosis, which is a topic he outlined in greater detail in ...
The Emergence of Philanthropy to Fund High-Risk, High-Reward Cancer Research
Jo Cavallo
Earlier this year, Sean Parker, the cofounder of the music streaming service Napster and an early president of Facebook, joined a growing list of entrepreneurs who are committing large portions of their wealth to funding cancer research. In April, Mr. Parker announced he was donating $25...
A Lung Cancer Specialist Talks About Value in Cancer Care
Ronald Piana
Over the past few years, the term value-based cancer care has become integrated into the vernacular of the oncology community. Value is a subjective term, which is defined largely by its clinical setting. However, value in cancer care is evaluated by the multiple stakeholders involved in...
How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality
Jo Cavallo
It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written ...
How ASCO Is Preparing Members for MACRA
Jo Cavallo
On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) announced its final policy on what physicians need to do to begin implementing the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Progra...
With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key
Caroline Helwick
The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP...
Which Factors Influence Radiotherapy for Brain Metastases?
Caroline Helwick
The advent of more effective systemic therapies, which extend patients’ lives, has also resulted in an increasing incidence of brain metastases, for which clinicians must determine appropriate treatment. Whole-brain radiotherapy has been the traditional treatment modality, but stereotact...
Using Watson to Analyze Genomic Data to Personalize Treatment for Patients With Cancer
Three years ago, IBM’s Watson supercomputer was best known for defeating two former champions on the TV game show Jeopardy! Today, it is grabbing headlines for becoming an important assistant in cancer care. Able to read and understand millions of pages of text within seconds, Watson caught the att...
Lung Cancer Specialist Shares Clinical Pearls for Managing Stage IIIA Non–Small Cell Lung Cancer
Caroline Helwick
Clinicians face a number of questions in evaluating and treating patients with stage IIIA non–small cell lung cancer (NSCLC). One expert in the field, Rafael Santana-Davila, MD, reviewed key issues in managing this disease in the Journal of Oncology Practice (JOP). The ASCO Post asked Dr...
An Oncologist Battles a Preventable Epidemic: Cancer of the Cervix
Ronald Piana
Cervical cancer incidence and mortality rates—perhaps more than any other chronic disease—shine a grim spotlight on global disparities of care. It is one of the most preventable of human malignancies, yet it is the leading cause of cancer deaths in women around the world. It kills 260,00...
Why Patients’ Understanding of Their Prognosis Often Differs From Their Oncologists’
Jo Cavallo
A recent study1 published in the Journal of Clinical Oncology (see “Breaking the ‘Conspiracy of Silence’” in this issue of The ASCO Post) found that just 1 in 20 patients with advanced, incurable cancer has sufficient understanding of his or her prognosis or life expectancy. Now, another...
Management of Merkel Cell Carcinoma
Caroline Helwick
A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the chan...
Multitude of Mentors Help Shape an Illustrious Career in Oncology
Ronald Piana
Sumanta K. Pal, MD, has had a longer career in oncology than many other colleagues his age. Perhaps the reason for that may center on his starting college at the age 13 and medical school at the age of 17. Today this internationally recognized leader in genitourinary cancers is Assistant Professor...
Addressing the Significant Disparities and Barriers to Health Care Experienced by LGBT Cancer Survivors
Jo Cavallo
In 2011, the Institute of Medicine (IOM) published its landmark report “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding,” which recognized the scarcity of research in lesbian, gay, bisexual, and transgender (LGBT) individuals and the n...
USPSTF Issues Final Research Plan to Screen for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults, Including LGBTQ Population
The ASCO Post
On August 25, 2016, the U.S. Preventive Services Task Force (USPSTF) posted a final research plan on screening for intimate partner violence, elder abuse, and abuse of vulnerable adults. The draft research plan for this topic was posted for public comment from May 26 to June 22, 2016. The Task Force...
How the Oncology Center of Excellence Plans to Foster Collaboration Among Researchers to Advance Cancer Treatment
On June 29, 2016, Robert M. Califf, MD, MACC, the Commissioner of the U.S. Food and Drug Administration (FDA), announced the selection of Richard Pazdur, MD, FACP, as Acting Director of the FDA’s newly created Oncology Center of Excellence. The center was created in response to the overa...
Late Cardiac Effects of Cancer Treatment
The combination of more precise diagnostic tools and advances in surgery, chemotherapy, radiation therapy, and targeted therapy in the treatment of cancer has led to unprecedented numbers of cancer survivors in the United States—more than 15.5 million, according to the latest figures fro...
Making a Difference in the Lives of Others
Quyen D. Chu, MD, MBA, FACS, this year’s recipient of ASCO’s Humanitarian Award, lives by the axiom that “One person can make a positive difference in the lives of others.” Although the term has become cliché, the experiences in Dr. Chu’s life and oncology career prove just how profoun...
Charting a New Course at the FDA
In February, after serving for a year as the U.S. Food and Drug Administration’s (FDA’s) Deputy Commissioner for Medical Products and Tobacco, Robert M. Califf, MD, MACC, was named the agency’s Commissioner of Food and Drugs. Prior to his appointment at the FDA, Dr. Califf was the Donald...
Using Social Media to Accelerate Genomic Research
The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique. And...
The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative
Caroline Helwick
A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with rese...
The National Cancer Moonshot Lifts Off
Just 6 months after President Barack Obama announced the establishment of a National Cancer Moonshot Initiative to accelerate the pace of research discoveries, improve patient access and care, and encourage data-sharing, dozens of new initiatives to accomplish those and other goals were rolled out a...
ASCO Releases the Updated Version of Its Value Framework
Last June, ASCO published its initial concept for a value framework in the Journal of Clinical Oncology (JCO).1 The framework, developed by ASCO’s Value in Cancer Care Task Force, is designed to provide a standardized approach to assist physicians and patients in assessing the “value” of a new ...
Medical Decision-Making: At the Heart of Care for Older Patients With Cancer
Although oncology has moved toward a personalized approach to care, medical decision-making within the context of multidisciplinary care has broad public health implications. To shed light on this and other relevant issues, The ASCO Post recently spoke with William Dale, MD, PhD, of the University...
Cervical Cancer Prevention Badly Needed in India
With the advent of the Papanicolaou (Pap) test and population-based screening, along with the development of the human papillomavirus (HPV) vaccine, cervical cancer has become a largely preventable disease for many. However, in India, cervical cancer is a leading cause of cancer mortality. To bet...
A Conquer Cancer Foundation Award Helps to Launch a Pioneering Study in Liposarcoma
Mark A. Dickson, MD, has been fascinated by science and medicine since he was in high school. After graduating magna cum laude from Harvard University in 1999, Dr. Dickson pursued a medical degree from the College of Physicians and Surgeons at Columbia University in New York. Once he decided on a ...
Extending ASCO’s Influence Globally to Improve Patient Care
On June 27, 2016, Clifford A. Hudis, MD, FACP, FASCO, will begin his tenure as Chief Executive Officer of ASCO, succeeding Allen S. Lichter, MD, FASCO, who presided over the Society and the Conquer Cancer Foundation of ASCO since 2006. Dr. Hudis’ dedication to ASCO dates back more than 25 years ...
Prostate Cancer: Opinions Vary on Gleason Scores and Surgery
Diagnosis and treatment of prostate cancer have been the source of heated debate for decades, most of which has centered on the clinical value of the prostate-specific antigen (PSA) test. In 2012, the U.S Preventive Services Task Force (USPSTF) gave the PSA test a D grade, which discourages many...
Rising Breast Cancer Incidence in Sub-Saharan Africa: Challenges and Opportunities
The incidence of new cases of breast cancer in low- and middle-income countries, particularly in sub-Saharan Africa, is rising, and it will take a concerted effort from the international cancer community to counteract this troubling upward trend. It has been estimated that of the 15 million cancer ...
In Celebration of a Remarkable Career at ASCO
In March, ASCO announced that Allen S. Lichter, MD, FASCO, was stepping down as Chief Executive Officer (CEO) at the end of June, ending his 10-year tenure as head of the Society and the Conquer Cancer Foundation of ASCO. Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service and Vice Pre...
ASCO Past-President Anticipates a New Position With an Ongoing Goal of Advancing the Field of Oncology
After an extensive national search, Hartford HealthCare has appointed ASCO Past-President Peter Paul Yu, MD, FACP, FASCO, as the first Physician-in-Chief of the Hartford HealthCare Cancer Institute. As Physician-in-Chief, Dr. Yu will be responsible for working closely and collaboratively with phys...
Occupational Therapy for Adults With Cancer: An Unmet Need
Adults with cancer are at high risk for functional limitations that would negatively affect their quality of life. Occupational therapy offers a range of supportive services, with the specific goal of helping these patients engage in life as independently as possible. To provide a better understan...
Monitoring Survivors of Childhood Cancers for Late Effects of Treatment
This past January, ASCO held its inaugural Cancer Survivorship Symposium, which brought together the fields of medical oncology and primary care to address the critical need for coordinated care for cancer survivors. Among the presenters at the symposium was Smita Bhatia, MD, MPH, who gave the k...
Oncology and Diplomacy in the Middle East
The Middle East is a vast region comprised largely of developing nations with complicated sociopolitical challenges, violent internecine disputes, and deeply fragmented health-care systems. Not surprisingly, the region’s suboptimal health care contributes to the late diagnosis and poor survival ...
How Immunotherapy Is Revolutionizing Cancer Care
More than 100 years after William B. Coley, MD, used bacterial toxins to goad the immune system into recognizing cancer cells as foreign to the body and mount an immune response to go after and kill them, the recognition of immunotherapy as a powerful anticancer therapy is finally being...
Breast Cancer Research Foundation: Revitalizing Academic Research in Breast Cancer Through Drug Research Collaborative
When Evelyn H. Lauder was diagnosed with breast cancer in 1989, she became a vocal spokesperson for women’s health, and in 1993, along with Larry Norton, MD, now Deputy Physician-in-Chief for Breast Cancer Programs and Medical Director of the Evelyn H. Lauder Breast Center at Memorial Sloan Ketterin...
Breaking Down Dogma With the Outgoing President of SGO
Chase Doyle
At the 2016 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, The ASCO Post sat down with the SGO’s outgoing President, Robert L. Coleman, MD, and discussed the revolutionary potential of blood biomarkers, why enhanced recovery after surgery protocols is a significant innovat...
Benefits and Risks of Transplantation: The Changing Therapeutic Paradigm for Multiple Myeloma
Although high-dose chemotherapy plus autologous transplantation has been a standard of care in the treatment of younger patients with newly diagnosed multiple myeloma, the advent of effective novel agents for the cancer over the past 15 years has raised the question of whether transplantation, with ...
Drug Prices and Value: Finding Middle Ground
The advent of targeted therapies along with complex personalized treatment regimens has added many effective tools to the oncology armamentarium. But progress has a price tag. Although the oncology community needs new drugs, there is growing concern that the price of many newer compounds is untenabl...
Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management
Caroline Helwick
Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most co...
Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer
Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to 39-yea...
The Time Is Now for the Worldwide Cancer Community to Be Proactive
The ASCO Post recently spoke with nationally recognized surgical oncologist Chandrakanth Are, MBBS, MBA, FRCS, FACS, Jerald L & Carolynn J. Varner Professor of Surgical Oncology & Global Health; Vice Chair of Education; and Program Director, General Surgery Residency, University of Nebraska ...
ASCO’s Incoming President-Elect Charts His Course for 2017
Bruce E. Johnson, MD, FASCO, was elected ASCO President for the 2017–2018 term this past December and will take office as President-Elect during the ASCO Annual Meeting, June 3–7, 2016, in Chicago. As an ASCO member since 1986, Dr. Johnson brings over 30 years of experience with ASCO to the position...
Cancer Registries and the Evolving Role of Big Data in Cancer Care
Ronald Piana
In 1956, the American College of Surgeons encouraged the development of hospital-based registries, but for the most part, these efforts were clumsy, inaccessible card files of data. Today, advanced microcomputer technology has increased the ability to not only collect and cull cancer data but also t...
Looking at the Real-World Effects of Genetic Testing
Ronald Piana
According to the most recent estimates, 55% to 65% of women who inherit the BRCA1 mutation and about 45% of women who inherit the BRCA2 mutation will develop breast cancer by the time they are 70 years old. There is also a substantial increase in the probability of developing ovarian cancers in wome...
The Promise of Immune Checkpoint Blockade in Cancer Therapy
Ronald Piana
The concept of using activation of the innate immune system and an inflammatory response against a bacterial component to instigate an antitumor response was studied in the 1960s, which led to the development of intravesical bacillus Calmette-Guérin, now used in the treatment of superficial bladder ...
Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option
Caroline McNeil
Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few olde...
Understanding Health-Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Patients to Ensure More Effective Cancer Care
Jo Cavallo
A new study examining the health-care needs of lesbian, gay, bisexual, and transgender/transsexual patients has found myriad disparities in access to cancer care.1 The researchers reviewed nearly 170 papers published over the past 15 years on the health-care needs among this population. Although the...
Evidence-Based Practice Needed in End-of-Life Care
Ronald Piana
Evidence-based oncology practice is a systematic approach to problem solving for cancer care providers, characterized by the use of the best evidence currently available for clinical decision-making. Over the past several decades, the oncology community, led by its major organizations such as ASCO a...
The Complex Interactions of Treatment Costs, Clinical Outcomes, and Patient Expectations
Ronald Piana
A clinical dilemma that is receiving a great deal of attention in the oncology community is the undue financial burden some patients face during their treatment and into survivorship. While much emphasis is put on methods to reduce and help patients navigate the complex payment system, little is kno...
Practicing the Humanistic and Holistic Approach to End-of-Life Care
Jo Cavallo
In 1990, when Bruce (B.J.) Miller, MD, was an undergraduate at Princeton University, the practice of medicine was far from his mind. Then a student in Chinese and Asian studies and later an art history major, Dr. Miller would come to pursue a career specializing in palliative medicine after an acci...
A Swiss Psychotherapist Gives Her Perspective on Optimal Palliative Care
Ronald Piana
Over the past few decades, the oncology community has incorporated new evidence-based therapies to address the psychosocial needs of patients with cancer, especially those with advanced disease. To bring a global perspective to this evolving discipline, The ASCO Post recently spoke with Monika Renz,...
Integrating Spirituality Into Palliative Care Services
Ronald Piana
Over the past couple of decades, the oncology community has made great strides in mediating the psychosocial needs of our patients. However, a patient’s spirituality is a subjective and uncomfortable issue for many oncologists, which leaves a gap in the continuum of care. To reach a better understa...
The State of Progress in Hematologic Malignancies
Jo Cavallo
The number of targeted therapies approved by the U.S. Food and Drug Administration (FDA) in the treatment of a variety of cancers, especially hematologic malignancies, continues to rise. In 2014 alone, 4 of the 10 new agents directed at discrete molecular targets approved by the FDA were for blood c...
How QOPI® Is Improving Oncology Care
Jo Cavallo
Launched in 2002 as a pilot program to promote excellence in oncology care, the origins of ASCO’s Quality Oncology Practice Initiative (QOPI®) date as far back as 1997, when the Institute of Medicine (IOM) created a National Cancer Policy Board to assess the state of cancer care in the United States...
ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers
Jo Cavallo
Two years ago, Richard L. Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical s...
Engaging Clinicians in the Collection of Cancer Registry Data to Improve Clinical Research
Jo Cavallo
In June, the Commission on Cancer of the American College of Surgeons published a revision of its Facility Oncology Registry Data Standards (FORDS) manual, which contains all the data items, codes, and rules to abstract data into cancer registries at the more than 1,500 Commission on Cancer–accredit...
End-of-Life Clinical Decisions Still Need Conversations About Improving Care
Ronald Piana
In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology communit...
Why Melanoma Rates Are Increasing in Adolescents and Young Adults, Especially Among Females
Jo Cavallo
The incidence of melanoma among children, adolescents, and young adults has reached epidemic proportions, increasing more than 250% over the past 4 decades, with young females at highest risk for the deadly cancer, according to a study1 by researchers at Roswell Park Cancer Institute in Buffalo, New...
Bridging the Gap Between Pediatric and Adult Oncology Care
According to the National Cancer Institute (NCI), about 70,000 adolescents and young adults—defined by the NCI as those in the 15- to 39-year-old range—are diagnosed with cancer each year in the United States, about six times the number of cases diagnosed in children aged 0 to 14.1 And, although ove...
Male Breast Cancer: An Understudied Disease and Clinical Challenge
Ronald Piana
Male breast cancer is an uncommon disease, although the incidence has increased over the past couple of decades. As with many other “orphan” diseases, male breast cancer is understudied, especially in randomized controlled trials. Although it shares similarities with female breast cancer, some impor...
The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain
The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...
A Cancer Care Model for Rural Areas
Ronald Piana
Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the T...
Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs
Jo Cavallo
In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these proposa...
One Doctor’s Road to Palliative Care Services in the Inner City
Ronald Piana
St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...
Charting a New Course: From Clinical Investigator to University President
Jo Cavallo
What first intrigued Fadlo R. Khuri, MD, FACP, about the prospect of becoming the 16th President of the American University of Beirut (AUB) in Lebanon was the chance to give back to an institution and a country that had given him so much. Born in Boston, Massachusetts, in 1963, Dr. Khuri was raised ...
The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version
Jo Cavallo
Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...
Calculating the Value of Cancer Drugs
For nearly a decade, Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, has been a leading voice in sounding the alarm over the escalating cost of cancer drugs and in seeking a solution to the problem. In 2012, Dr. Ba...
Past President of ASCO Takes on New Role at Memorial Sloan Kettering Cancer Center to Improve Patient Care and Public Health
In June, Memorial Sloan Kettering Cancer Center (Memorial) in New York announced it had appointed Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service, to a newly created position of Vice President for Government Relations and Chief Advocacy Officer. In addition to his new role, Dr. Hudis ...
The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning
Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The stud...
Translating Study Recommendations Into Medicare Coverage
Lung cancer doggedly remains the leading cause of cancer-related death in the United States. This grim mortality figure is due, in part, to a lack of early detection methods; more than half of all lung cancers have metastasized at the time of diagnosis. For decades, lung cancer advocates lobbied for...
ASCO Releases Details of Its Conceptual Framework for Assessing Value in Cancer Care
Defining and ensuring the delivery of high-value oncology care has been one of ASCO’s major goals for more than a decade. In 2007, ASCO formed the Task Force on the Cost of Cancer Care, now called the Value in Cancer Care Task Force, to identify the drivers of the increasing costs of oncology care (...
Deciphering the Genetic Variability of Cancer to Advance Precision Oncology Care
In 2014, Memorial Sloan Kettering Cancer Center (MSKCC) in New York opened the Marie-Josée and Henry R. Kravis Center for Molecular Oncology with the sole purpose of expediting the translation of novel molecular discoveries into clinical innovations to turn the goal of precision oncology care into a...
Redefining Cancer
The ability to interrogate cancer cells at the genomic, proteomic, immunologic, and metabolomic levels will transform oncology care from one that relies mainly on trial-and-error treatment strategies based on the anatomy of the tumor to one that is more precisely based on the tumor’s molecular profi...
Fulfilling NCI’s Commitment to Supporting the Best Science
On April 1, 2015, Douglas R. Lowy, MD, became Acting Director of the National Cancer Institute (NCI), succeeding Harold Varmus, MD, who left NCI to join the faculty of Weill Cornell Medical College in New York. (See “The Next Step in a Storied Career,” in the May 25, 2015 issue of The ASCO Post.) D...
Managing Breast Cancer in 2015
Since 1990, we have seen an approximate 35% reduction in breast cancer mortality among women in the United States. Three protagonists can share this clinical success story: prevention, early detection, and better therapies. To shed light on the current state of breast cancer research and therapy, Th...
Will the PVS-RIPO Poliovirus Be a Game Changer in the Treatment of Recurrent Glioblastoma?
Although the idea of using viruses to target cancer cells dates back more than 100 years, technologic advances in the genetic engineering of viruses are now making it possible to safely test oncolytic virotherapy as a valid strategy against cancer cells. One type of genetically engineered virus that...
Taking the Next Step in a Storied Career
On March 31, 2015, Harold Varmus, MD, left his position as Director of the National Cancer Institute (NCI) to join the faculty of Weill Cornell Medical College in New York as its Lewis Thomas University Professor of Medicine. Dr. Varmus was also named Senior Associate Core Member of the New York Gen...
The Mechanisms Driving Cancer Pain
For over a decade, Patrick W. Mantyh, PhD, JD, has been investigating the molecular and cellular mechanisms that are involved in cancer-related pain, especially bone pain caused by advanced breast, prostate, and lung cancers. His early laboratory work using mouse models of bone cancer led to an und...
Learning to Communicate Science More Effectively
Alan Alda’s passion and appreciation for science extend nearly as far back to his early life as his love of acting. The son of actor Robert Alda, Mr. Alda began his acting career at the age of 16. Although he has appeared in such widely acclaimed films as The Seduction of Joe Tynan, Crimes and Misde...
Bombarded With Changes in Health Care and Beyond, Gynecologic Oncologists Prepare for the Challenges Ahead
Charlotte Bath
Physicians are being “bombarded” with changes in health care and beyond, Richard R. Barakat, MD, FACS, noted in his Presidential Address at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. These changes are being precipitated by steeply rising health-care costs amid federa...
20 Years of NCCN: The Best Is Yet to Come
Caroline Helwick
As the National Comprehensive Cancer Network (NCCN) celebrates its 20th year, The ASCO Post asked its Chief Executive Officer, Robert W. Carlson, MD, to reflect on the organization’s accomplishments, mission, and future and on the role he may have played in its success. The Early Years You became...
Opioid-Reduction Strategy for Postoperative Pain After Breast Cancer Surgery
Ronald Piana
One persistent and potentially debilitating problem breast cancer patients suffer with is postoperative pain. Studies show that proper pain management is an essential component in the healing process, but undertreatment of pain symptoms remains an ongoing issue in the oncology community. Opioids, wh...
In Search of ‘Just’ Prices: Questioning the High Cost of New Cancer Drugs
As the oncology community begins the slow and often difficult-to-define transition from volume to value in the delivery of cancer care, the relationship between the price and value of certain high-priced cancer drugs is getting more scrutiny. We generally correlate the efficacy of a new drug and its...
Current Progress Against Cancer and What Lies Ahead in the Next Decade
In January, ASCO released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer,1 which details research advances over the past decade that have led to longer survival and better quality of life for the more than half-a-million people diagnosed with cancer each year....
The Emerging Role of Radiation Therapy in Gastrointestinal Cancers
The use of radiation therapy in the treatment of gastrointestinal cancer has evolved over the past several decades, in a gradual, stepwise fashion. Since most gastrointestinal cancers are diagnosed at a locally advanced stage, coupled with the inherent sensitivity of most parts of the gastrointestin...
Why Just Having ‘Good’ Communication Skills Is Not Enough for Talking With Seriously Ill Patients
In the Institute of Medicine’s 2014 report Dying in America,1 the report’s authors found that while frequent clinician-patient conversations about end-of-life care, goals, and preferences are necessary to avoid unwanted treatment, most patients do not have those conversations with their physicians. ...
The Ongoing Struggle Against Tobacco: Past Accomplishments, Future Steps
In 1913, 10 doctors and 5 laypersons in New York founded the American Cancer Society (ACS). At that time, a cancer diagnosis was almost always fatal and was rarely discussed in public. The Society’s original charter was to raise awareness about cancer, and although that mission has remained firm, ov...
Our Aging Population: Challenges in Caring for Older Patients With Cancer
Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging popu...
Ongoing Controversies in Allocating Our Health‑Care Resources
Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care resour...
Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients
A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...
Five Questions Can Guide the Treatment of Relapsed Myeloma
Caroline Helwick
Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10 yea...
Determining Why Not All Patients Respond to PD-1 Inhibitors
Recent research1 conducted by Robert H. Pierce, MD, and his colleagues investigating why PD-1 (programmed cell death protein 1) inhibitors result in remarkably durable clinical remissions in some patients with melanoma, whereas others reap a short-term benefit or no benefit at all is showing that re...
Treating Head and Neck Cancer in 2015
Each year in the United States, about 55,000 people will be diagnosed with head and neck cancer, and of them, about 12,000 will die of the disease. Although advances have been made in the treatment of head and neck cancer, this disease remains persistently problematic, due, in part, to the complex a...
The Current State of Hematologic Malignancies
Due in part to the refinement of bone marrow transplantation and its many innovations, some leukemias that once were death sentences now have cure rates of up to 90%. As research in transplantation and other promising areas accelerates, we are on the verge of breaking new clinical boundaries in bloo...
Improving the Quality of Palliative Care in Oncology
Two years ago, ASCO collaborated with the American Academy of Hospice and Palliative Medicine to develop the Virtual Learning Collaborative, a virtual quality improvement program intended to address the complex care needs of patients with advanced cancer and the care quality for all patients with ma...
Telling the Story of Cancer
Acclaimed documentarian Ken Burns (The Civil War, Baseball, Jazz, The Central Park Five, and The Roosevelts: An Intimate History) has been making films for more than 35 years. His most recently completed project, scheduled to air on PBS this spring, is Ken Burns Presents Cancer: The Emperor of All M...
The Journey From Book to Film
Soon after publication of The Emperor of All Maladies: A Biography of Cancer (Scribner) in 2010, the book’s author Siddhartha Mukherjee, MD, PhD, received a call from Laura Ziskin, a film producer and cofounder of Stand Up To Cancer, who was interested in obtaining the film rights to Dr. Mukherjee’s...
Treating Bladder Cancer in 2015
Ronald Piana
Treatment of advanced bladder cancer continues to prove challenging, and therapies that offer long-term survival remain elusive. The ASCO Post recently spoke with Derek Raghavan, MD, PhD, FACP, FRACP, FASCO, President of the Levine Cancer Center, Charlotte, North Carolina, about the current state of...
Transitioning From Volume to Value in Cancer Care
Ronald Piana
In an oncology health-care system that is increasingly changing its delivery and payment models, how do busy oncologists successfully bridge the transition from a volume- to value-based, patient-centric model? This, and other topics on value fueled a robust discussion at the Association of Community...
Unraveling the Mysteries of Epithelioid Hemangioendothelioma
Jo Cavallo
Epithelioid hemangioendothelioma is a rare and devastating vascular sarcoma that affects between 100 and 200 people, mostly young adults, each year in the United States. The cancer may arise as a solitary lesion but more commonly presents with metastatic involvement, usually in the liver and lungs. ...
Colorectal Cancer 2015
Ronald Piana
Despite advances in detection and treatment, colorectal cancer remains the third deadliest cancer among men and women in the United States. To get a better understanding of the current state of this disease and what lies ahead, The ASCO Post recently spoke with colorectal cancer expert John L. Marsh...
Breast Health Global Initiative Tackles Third-World Health Care
Alice Goodman
Benjamin O. Anderson, MD, is the Director of the Breast Health Global Initiative (BHGI) and surgical oncologist and Director of the Breast Health Clinic at the University of Washington in Seattle. The ASCO Post recently spoke with Dr. Anderson about the conceptual framework of the risk-stratificatio...
Smarter Trial Design Saves Money and Produces Better Drugs
Ronald Piana
The process of identifying a promising molecule and moving it from the laboratory through the highly complex series of clinical trials necessary to garner U.S. Food and Drug Administration (FDA) approval is a costly scientific gauntlet during which many new agents fail. New trial design, pharmacolog...
What It Means to Be Mortal
“I learned a lot of things in medical school, but mortality wasn’t one of them,” writes Atul Gawande, MD, MPH, in his new book on the medicalization of aging and dying, Being Mortal: Medicine and What Matters in the End (Metropolitan Books, 2014). In the book, Dr. Gawande critiques the American medi...
Incorporating Physical Medicine and Rehabilitation Into Palliative Care
Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with ca...
Benefits of Exercise for Relieving Fatigue in Cancer Survivors
Jo Cavallo
Fatigue is such a common—and ongoing—problem among cancer survivors, last spring, ASCO published a clinical practice guideline1 to address screening, assessment, and treatment approaches for the management of fatigue after patients have completed treatment. Among the strategies included in the guide...
Palliative Care in 2014
Ronald Piana
Palliative care expert Diane E. Meier, MD, is the Director of the Center to Advance Palliative Care (CAPC), a national organization devoted to enhancing the number and quality of palliative care programs across the nation. Under her leadership, the number of palliative care programs in the United St...
The Harvard Global Equity Initiative: From Research to Policy
Ronald Piana
The Harvard Global Equity Initiative is a research program at Harvard University that is dedicated to promoting equitable global development, with a strong emphasis on health-care issues. This initiative brings together scholars, policymakers, advocates, and practitioners from around the world to ad...
Advancing ASCO’s Commitment to Quality to Ensure That Every Patient Receives the Highest Level of Cancer Care
On December 3, 2014, Robert S. Miller, MD, FACP, FASCO, will start his new position as Medical Director of ASCO’s Institute for Quality (iQ). Established in 2012 to oversee the development of clinical practice guidelines, the Quality Oncology Practice Initiative (QOPI), the QOPI Certification Progra...
Treating Brain Cancer in 2014
Ronald Piana
While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest, respec...
Helping Adolescents and Young Adults Cope With Cancer
Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are curre...
How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer
A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants re...
Striving for Quality, Not Quantity, of Life
Jo Cavallo
Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of 78....
Expert Point of View: Stefan Sleijfer, MD, PhD
Alice Goodman
Formal discussant of the PAZOGIST trial at the European Society for Medical Oncology (ESMO) 2014 Congress, Stefan Sleijfer, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, said “The title of my talk is ‘Small Molecules: Greater Success,’ and we are not yet there.” He agreed wit...
Pancreatic Cancer in 2014
Ronald Piana
Adenocarcinoma of the pancreas is the fourth leading cause of cancer death in men and women in the United States. This year, about 46,000 people in this country will be diagnosed with pancreatic cancer, and more than 39,000 will die of the disease. The ASCO Post recently spoke with Margaret A. Tempe...
Addressing Patients’ Sexual Dysfunction Throughout Survivorship
Jo Cavallo
Studies show that all cancers and related treatments have the potential to affect sexuality and sexual function. Surgery, chemotherapy, hormonal therapy, bone marrow transplantation, and radiation therapy can physically impact sexual health in myriad ways, including vaginal dryness, dyspareunia, and...
Dying in America: Ensuring High-Quality Care at the End of Life
Jo Cavallo
In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...
Partnering With Community Centers to Advance Oncology Care
Last fall, Richard R. Barakat, MD, FACS, the Ronald O. Perelman Chair in Gynecologic Surgery at Memorial Sloan Kettering Cancer Center, was named to the new position of Deputy Physician-in-Chief for the Memorial Sloan Kettering Regional Care Network and Cancer Alliance, a new initiative meant to fos...
Treating Testicular Cancer in 2014
Ronald Piana
Testicular cancer is one of oncology’s true success stories. It is a highly treatable disease, usually curable, that most often develops in young and middle-aged men. Despite the success in testicular cancer, there are still clinical challenges ranging from staging to optimum therapeutic approaches....
Attaining the Goal of Preventing Ovarian Cancer
Fifteen years ago, David Fishman, MD, launched the National Ovarian Cancer Early Detection Program as part of the National Cancer Institute’s Early Detection Research Network. The goal of the research effort was to develop methods to accurately detect ovarian cancer while it was still confined to th...
Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists
Ronald Piana
Each day, millions of patients with cancer around the world suffer unrelieved pain because they are denied morphine, the gold standard of cancer pain control. The World Health Organization has called access to morphine a human rights issue. Not surprisingly, the crisis in unrelieved cancer pain is a...
Treating Sarcomas in 2014
Ronald Piana
In 2014, about 15,000 people in the United States will be diagnosed with some form of sarcoma, and of those, approximately 5,000 adults and children are expected to die of the disease. Sarcomas are a heterogeneous group of mesenchymal malignancies that have historically been difficult to diagnose an...
The Value of Lifelong Mentorship in Career Development
While the development of mentorship relationships is critical in launching and nurturing the academic careers of young investigators, it is also an essential component for continued success throughout their careers, according to Jennifer R. Brown, MD, PhD. Dr. Brown, Director of the CLL Center at Da...
On Being A Mentee and the Value of the Conquer Cancer Foundation’s Career Development Award
At the ASCO Annual Meeting in June, the Conquer Cancer Foundation presented the 2014 recipients of prestigious grants and awards, including the Young Investigator Award, Career Development Award, and the Advanced Clinical Research Award in Breast Cancer. In announcing the awards, Charles W. Penley, ...
Now in Its 71st Year, CancerCare Looks to Expand Services to Patients and Caregivers
Eleven days before Patricia J. Goldsmith, joined CancerCare as its CEO last May, she received the unexpected news that she had early-stage colorectal cancer. While the diagnosis was shocking, Ms. Goldsmith said it gave her a unique perspective on what it means to have this serious disease and a gre...
Helping Patients Talk to Their Children About Cancer
Although the focus of an oncologist’s attention is understandably attuned to the needs of the patient, when a patient is a parent, quality oncology care should also include attention to the patient’s role as a parent and to the needs of the patient’s children, according to Paula K. Rauch, MD, Foundi...
National Cancer Institute Launches the National Clinical Trials Network to Expedite Scientific Advances
Jo Cavallo
In March, the National Cancer Institute (NCI) transformed its Cooperative Group Program into the National Clinical Trials Network (NCTN). Spurred by recommendations in the Institute of Medicine (IOM) 2010 report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI C...
Potential of Liquid Biopsies in Detecting Cancer and Establishing Prognosis
Jo Cavallo
Tests in development to detect circulating tumor cells that escape from solid tumors and travel through the blood, spreading cancer to new sites, may serve as an alternative to conventional tissue biopsy for early cancer diagnosis and gene-expression analysis over the next decade. According to Massi...
How Evolutionary Game Theory Is Offering Clues to Disrupt Cancer Cell Metabolism
Jo Cavallo
Kenneth J. Pienta, MD, and his colleagues at Johns Hopkins Medicine in Baltimore are using the principles of evolutionary game theory to learn how cancer cells cooperate within a tumor to gather energy and metastasize. Game theory, the mathematic study of strategic decision-making that is commonly u...
Emerging Approaches in Acute Myeloid Leukemia
Caroline Helwick
With the emergence of molecular diagnostics and new therapeutics, the treatment of acute myeloid leukemia (AML) is entering a new era. Hugo F. Fernandez, MD, Associate Chief of Blood and Marrow Transplantation at Moffitt Cancer Center in Tampa, Florida, spoke with The ASCO Post about how he approach...
Understanding the Impact of Results From CALGB/ SWOG 80405 and Other New Data in Colorectal Cancer
The ASCO Post
The Cancer and Leukemia Group B (CALGB)/Southwest Oncology Group (SWOG) 80405 trial, presented during the Plenary Session at this year’s ASCO Annual Meeting, demonstrated that cetuximab (Erbitux) and bevacizumab (Avastin) confer similar benefits as first-line treatment with chemotherapy for KRAS wil...
The Role of Integrated Palliative Care in Radiation Oncology
Jo Cavallo
Three years ago, Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston, launched a Supportive and Palliative Radiation Oncology (SPRO) program to integrate generalist palliative oncology services, including the physical, psychosocial, and spiritual aspects of care, into radiation t...
Identifying Impending Death Helps Patients and Caregivers
Ronald Piana
Significant weight loss, cachexia, and being bedbound signal that a cancer patient is dying. However, identifying the specific signs that give physicians the ability to predict death is not well described in the literature. To better understand why predicting death is an important part of the care c...
How Pharmaceutical Companies Are Partnering With Patient Advocates to Ensure Access to Oncology Care
Jo Cavallo
Thomas P. Sellers, MPA, has been a tireless advocate for patients’ rights for more than 20 years. A 15-year prostate cancer survivor and only child, Mr. Sellers said it was his mother’s death from lung cancer when she was 51, followed by the death of his father from glioblastoma multiforme that led ...
The Evolving Role of Surgery in Germ Cell Tumors
Ronald Piana
Over the past several decades, the role of postchemotherapy surgery for advanced testicular cancer has evolved with regard to patient selection, surgical planning, lymph node dissection, and surgical technique. To add clarity to this complex clinical setting, The ASCO Post recently spoke with urolog...
More Collaboration Needed Between Oncologists and Primary Care Physicians
Ronald Piana
One of the most important cancer survivorship issues is the transition from oncologist to the primary care setting. With a growing population of cancer survivors, patients need to feel secure about their primary care provider having the tools to address their special needs. To shed light on this imp...
Prominent Immunotherapy Researcher Sees Success Beyond the Challenges
Ronald Piana
Activating the immune system for therapeutic benefit in cancer patients has long been a goal in the scientific community. After decades of disappointment, this intriguing approach has come to the forefront of cancer research, showing promising results in several malignancies. To keep abreast of this...
Discussing Sexual Health Issues With Female Cancer Survivors
Ronald Piana
Advances in cancer treatment have led to increasing numbers of long-term survivors, bringing greater attention to the needs of this growing population. Female cancer patients often experience difficult adjustments related to sexual health and intimacy. To better understand the complexity of this imp...
Using Patient-Reported Outcome Measures in Palliative Care Clinical Practice
Incorporating patient-reported outcomes into the palliative care clinical setting can improve patients’ symptom management, quality of life, and overall communication with their oncologists, according to Ethan Basch, MD. Dr. Basch is Director of the Cancer Outcomes Research Program and Associate Pro...
Oncologists Tell Inspiring Stories of What It’s Like to Treat Cancer in The Big Casino
Title: The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful StoriesEditors: Stan Winokur, MD, and Vincent CoppolaPublishing Platform: CreateSpacePublication date: May 2014Price: $9.99; Paperback, 160 pages In May, Stan Winokur, MD, and co-editor Vincent Coppola, published The ...
How Technology Is Helping Bring Health Care to Patients
The term “telemedicine,” which is sometimes used interchangeably with “telehealth” and “m-health” (for mobile health) and is now collectively called “connected health,” involves the use of information and communications technology to connect patients with their providers through a variety of electro...
Expert Point of View: Philip McCarthy, MD
Caroline Helwick
Melphalan, prednisone, and thalidomide (Thalomid), or MPT, was a widely accepted regimen in newly diagnosed multiple myeloma when the E1A06 trial was launched, noted Philip McCarthy, MD, Director of the Blood and Marrow Transplant Program at the Roswell Park Cancer Institute, Buffalo, New York. E1A0...
Expert Point of View: Axel Hauschild, MD
Caroline Helwick
Axel Hauschild, MD, Professor of Dermatology at the University Hospital Schleswig-Holstein, Campus Kiel, in Germany, discussed the evolving utility of intralesional approaches to melanoma in the ASCO Poster Highlights session. In general, he maintained that the overall and complete response rates a...
Expert Point of View: Carmen J. Allegra, MD
Caroline Helwick
Carmen J. Allegra, MD, Professor of Medicine and Chief of Hematology/Oncology at the University of Florida, Gainesville, who discussed the findings at the ASCO Annual Meeting, said the study upholds what has become the practice of many oncologists—to use adjuvant FOLFOX (fluorouracil/leucovorin/oxal...
Expert Point of View: Wendy Demark-Wahnefried, PhD, RD
Wendy Demark-Wahnefried, PhD, RD, Professor and Webb Endowed Chair of Nutrition Sciences at the University of Alabama at Birmingham, formal discussant for the SHAPE-2 and LEAN trials at the ASCO Annual Meeting, emphasized the importance of weight loss, but noted that it can be challenging for patien...
Expert Point of View: Jean-Yves Douillard, MD, PhD
Commenting on the RECOURSE data,1 ESMO spokesperson Jean-Yves Douillard, MD, PhD, Professor of Medical Oncology, Institut de Cancérologie de l’Ouest (ICO) René Gauducheau, Saint-Herblain, France, said, “The phase III trial of TAS-102 is a global study and confirms the results of the phase II study i...
The Road to Progress in Lung Cancer Treatment
Despite promising new agents and therapeutic approaches, 5-year lung cancer survival rates have lagged far behind those of most other malignancies. To shed light on some of the important issues facing lung cancer experts, The ASCO Post recently spoke with internationally recognized lung cancer resea...
ASCO Convenes Think Tank to Tackle Disparities in Cancer Care
Despite advances in cancer screening and in more effective therapies to treat the disease, which have led to improved outcomes and increased survival rates for millions of people with cancer, not every American is reaping the benefits of these advances. Disparities in health-care access, quality of ...
Advancing Immune Checkpoint Targeting in Cancer Treatment
James P. Allison, PhD, Professor and Chair of the Department of Immunology, Executive Director of the Moon Shots Immunotherapy Platform, and Deputy Directory of the David H. Koch Center for Applied Research of Genitourinary Cancers at The University of Texas MD Anderson Cancer Center, Houston, is re...
FDA Approval of Siltuximab for Multicentric Castleman’s Disease
INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, FDA hematologist/oncologist Albert Deisseroth, MD, PhD, discusses the recent approval of siltuximab for patients with multicentric Castleman’s disease who are human immun...
A New Era in the Management of Advanced HER2-Positive Breast Cancer
Karen Lisa Smith, MD, MPH, and Vered Stearns, MD
Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to d...
Issues in the Management of the Axilla in Patients With Breast Cancer
For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with Hiram...
Colon Cancer Prevention: It’s All About Mindset and Minute Details
G.S. Raju, MD, FACG, FASGE
I would like to congratulate Corley and his colleagues for their seminal work on the association between adenoma detection rate and risk of colorectal cancer, advanced colorectal cancer, and colorectal cancer mortality. The impact of their findings—reported in The New England Journal of Medicine1 an...
Genomic Confidence and Competence
Patrick M. Boland, MD, and Michael J. Hall, MD, MS
As reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Stacy W. Gray, MD, AM, a medical oncologist at Dana-Farber Cancer Institute, Boston, and colleagues presented one of the first studies evaluating how academic oncologists perceive the incorporation of a nove...
Sharing 50 Years of Christmas: A Quality Metric?
Chandrakanth Are, MBBS, MBA, FRCS, FACS
A very pleasant 68-year-old woman was referred to my clinic with biopsy-proven liver metastasis from primary colon cancer. She was initially diagnosed with colon cancer, which was resected, and she then received chemotherapy. A suspicious liver lesion was biopsied in the adjuvant setting, which conf...
Glioblastoma: Can We Make This Intractable Disease Tractable?
In the clinical array of brain tumors, glioblastoma is the most difficult to treat, and despite decades of research and the advent of new therapies, patients with glioblastoma continue to have a very poor prognosis. Leading brain tumor experts at the recent 25th Annual Cancer Progress Conference in ...
ASCO Guideline Update Extends Sentinel Node Biopsy Indications in Breast Cancer
Armando E. Giuliano, MD
The American Society of Clinical Oncology (ASCO) published its first guideline for sentinel lymph node biopsy in 2005.1 Since that time, many new randomized and cohort studies have been published investigating the indications and outcomes of the procedure. The updated 2014 guideline, recently publis...
Should Breast Cancer Patients With One to Three Positive Nodes Routinely Receive Postmastectomy Radiation?
Bruce G. Haffty, MD
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues to provide valuable clinically relevant and practice-influencing information garnered from individual patient-level data from numerous randomized trials in breast cancer. The large numbers of patients and long-term follow-up i...
Helping Young Adults Cope With Cancer
For young adults diagnosed with cancer, coping with the aftermath of the disease can be especially daunting. Although all cancer survivors share some common concerns and distress, for young adults grappling with body image, sexuality, peer pressure, dating, marriage, family planning, education, and ...
A Way Forward in Genomic Medicine
Over the past several decades, the convergence of scientific discovery, technology, and therapeutic developments has created an unparalleled opportunity to integrate our growing knowledge of genomics into the clinical practice of oncology. To shed light on the current state and future of genomics-dr...
Margin Reassessment in Breast-Conservation Therapy
Thomas A. Buchholz, MD, FACR, FASTRO
Significant progress has been made in local-regional and systemic treatments of breast cancer. Most patients currently diagnosed with breast cancer in the United States are diagnosed with early-stage disease and achieve excellent outcomes with breast-conservation therapy. Indeed, outcomes have sign...
Bringing Palliative Care Services to Local Community Clinical Practices and Health Facilities Throughout the World
In 2007, the Billings Clinic Cancer Center in Billings, Montana, became one of 15 community-based oncology centers nationwide to receive funding from the National Cancer Institute (NCI) to expand programs for clinical trials, health-care disparities outreach, survivorship and palliative care, multid...
ASCO Develops New Strategy to Increase Value in Cancer Care
Last January, ASCO held a leadership summit in Washington, DC, with representatives from the pharmaceutical industry, insurance payers, patient advocates, and physicians to address the skyrocketing costs of new drugs and technologies used in the diagnosis and treatment of cancer. Although costs are ...
Andrew D. Zelenetz, MD, PhD, on Treating the Elderly Lymphoma Patient With Elevated Bilirubin
Caroline Helwick
At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), lymphoma expert and NCCN Panel Chair on Lymphoma, Andrew D. Zelenetz, MD, PhD, fielded questions from oncologists. The ASCO Post was there to capture his recommendations for a common clinical scenario—treating the eld...
Cancer Chemotherapy Use During Pregnancy
INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, National Toxicology Program scientists Kembra L. Howdeshell, PhD, and Michael D. Shelby, PhD, discuss a recently completed monograph that reviews the published data on pr...
Beyond the Cystoscope: Thinkers and Technicians
Derek Raghavan, MD, PhD, FACP, FRACP, FASCO
I have spent my career working with urologists. Over a long period of time, I have concluded that they are fine and interesting people who work hard, live well, support interesting hobbies, generally take good care of their families, and are very enjoyable company at parties. The recent discussion ...
Getting It Right in the End: Individualization of Care for Patients With Rectal Cancer
Leonard Saltz, MD
Data from trials conducted mostly in the 1970s and 1980s established the paradigm that optimal treatment of rectal cancer requires a combination of radiation therapy, chemotherapy, and surgery.1 Virtually all of these trials, however, demonstrated that radiotherapy added only to the local control ra...
Setting a ‘Moon Shots’ Goal to Drastically Reduce Cancer Mortality Over the Next Decade
In 2012, just 1 year after taking the reins as President of The University of Texas MD Anderson Cancer Center, Ronald A. DePinho, MD, announced his plans to launch the Moon Shots Program, the most ambitious endeavor undertaken by the cancer center to dramatically accelerate the pace of reducing canc...
The Role of Psychosocial Supportive Services in Palliative Care
More than 2 decades ago, Deane L. Wolcott, MD, helped develop comprehensive patient-centered psycho-oncology care in cancer centers across the country. Today, many aspects of that patient-centered care, including psychiatric, dietary, pain management, cancer rehabilitation medicine, survivorship, an...
Creating a Comprehensive Catalog of Cancer Genes to Improve Patient Outcomes
In January, Eric S. Lander, PhD, Director of the Broad Institute of MIT and Harvard in Cambridge, Massachusetts, and his colleagues published the results from their landmark study,1 which explored the feasibility of creating a comprehensive catalog of cancer genes. The researchers collected and anal...
Thirty Years of Effort Has Led to the Mainstreaming of Integrative Medicine in Oncology Care
When Barrie R. Cassileth, MS, PhD, began researching complementary medicine and its potential for use in oncology care over 30 years ago, not much was known about the importance of complementary therapies for the well-being of patients with cancer. She chose to conduct her doctoral dissertation rese...
An Oncologic Surgeon Discusses the Pros and Cons of Pursuing a Business Degree
Is pursuing a Master of Business Administration (MBA) degree a good idea for ambitious surgical oncologists who want to advance their careers? The ASCO Post recently spoke with Martin J. Heslin, MD, MSHA, Chief, Section of Surgical Oncology, University of Alabama at Birmingham (UAB) Medical Center, ...
Expert Point of View: José Baselga, MD, PhD
Presentation of the PALOMA-1 trial results represented “the culmination of a long journey from the discovery of cyclin-dependent kinase (CDK) 4/6 in the early 1990s,” said José Baselga, MD, PhD, Physician-in-Chief at Memorial Sloan Kettering Cancer Center, New York. Dr. Baselga was formal discussant...
Expert Point of View: Gary Schwartz, MD
Formal discussant of the LY2835219 trial reported at the American Association for Cancer Research Annual Meeting, Gary Schwartz, MD, of Columbia University School of Medicine, New York, said the drug had “dramatic effects” in estrogen receptor–positive patients. “This drug is highly active in lumin...
Expert Point of View: Mario Sznol, MD
Mario Sznol, MD, of Yale Cancer Center, New Haven, Connecticut, was formal discussant of the MK-3475 presentations at the American Association for Cancer Research (AACR) Annual Meeting. He alluded to all the factors that complicate assays of PD-L1: the disparate nature of the assays themselves, the ...
Expert Point of View: William Cliby, MD
When asked to comment on the study presented by Lin et al at the Annual Meeting on Women’s Cancer, William Cliby, MD, Chair, Division of Surgery, The Mayo Clinic, Rochester, Minnesota, said, “This study is important because of its size and the utilization of the National Cancer Data Base—the largest...
Expert Point of View: David M. O’Malley, MD
David M. O’Malley, MD, Assistant Professor at The James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University College of Medicine, Columbus, commented on the abstract presented by Ward et al at the Annual Meeting on Women’s Cancer. “Dr. Ward and colleagues report further co...
Expert Point of View: Thomas J. Herzog, MD
PARP inhibitors are a very promising strategy that moves the treatment of ovarian cancer into the era of personalized medicine,” said Thomas J. Herzog, MD, Director of Gynecologic Oncology at Columbia University Medical Center, New York. “We now have a biomarker for identifying who will benefit fro...
Expert Point of View: Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD
In an editorial accompanying publication of the AURELIA study results, Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD, of Beth Israel Deaconess Medical Center, Boston, considered the implications of the benefits observed in the trial and limitations in interpret...
Bringing the Humanistic Approach to Palliative Care: From Diagnosis and Throughout Disease Course
For much of her career in oncology, Teresa A. Gilewski, MD, has sought to bridge the science of medicine with the humanistic aspect of care. She has created the Art of Medicine lecture series at Memorial Sloan Kettering Cancer Center in New York, where she is a medical oncologist on the Breast Cance...
The Outlook on Cancer Research in This Era of Leaner Federal Funding
In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of D...
State-of-the-Art Update on Renal Cell Carcinoma
Richard J. Boxer, MD, FACS
During the course of the 2014 Genitourinary Cancers Symposium, The ASCO Post had the opportunity to speak with several of the world’s leading authorities about the state of the art in screening, diagnosis, and treatment for prostate and kidney cancers. In this second installment of a two-part report...
A Conversation With David I. Quinn, MBBS, PhD, FRACP
Richard J. Boxer, MD, FACS
First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...
A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS
Richard J. Boxer, MD, FACS
Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this decl...
Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil
Therese B. Bevers, MD
The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone o...
The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations
Daniel B. Kopans, MD, FACR
If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and ...
Overdiagnosis of Breast Cancer: New Research Directions
Sudhir Srivastava, PhD, MPH, and Barnett S. Kramer, MD, MPH
Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...
Will Colorectal Cancer Surveillance Change Based on the Results of the FACS Trial?
Cathy Eng, MD, FACP
Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...
Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation
Ronald C. Chen, MD, MPH, and Anthony L. Zietman, MD
Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic an...
Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated
Kyle O. Rove, MD, Ty T. Higuchi, MD, PhD, and E. David Crawford, MD
The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a population-bas...
Detecting Accelerated Aging in Adult Survivors of Childhood Cancer
Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...
Overcoming Physician Bias in Recommending Palliative Care
In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life b...
Thyroid Cancer On the Rise: Is It Clinically Meaningful?
Caroline Helwick
According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The A...
Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts
Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs fac...
‘How Am I Doing, Doc?’
Victor G. Vogel, MD, MHS
The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,” and...
Unraveling the Molecular Complexity of Multiple Myeloma
In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed pati...
The FDA’s Bad Ad Program
The ASCO Post
INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, Robert Dean, MBA, Director, and Michael Sauers, Deputy Director, of Division II in the FDA’s Office of Prescription Drug Promotion discuss the FDA’s Bad Ad program. The ...
Transition From Busy Oncologist to Retiree: Challenges and Opportunities
Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician q...
Expert Point of View: James Gulley, MD, PhD
Alice Goodman
“The key thing about this trial is that while the overall study was negative, subset analysis suggests that the patients who appear to benefit from ipilimumab have better prognostic factors, including no visceral disease, lower alkaline phosphatase, and elevated hemoglobin,” commented James Gulley,...
Expert Point of View: Thomas W. Flaig, MD
Alice Goodman
This study has the potential to expand the number of patients who can benefit from organ-sparing therapy,” said Thomas W. Flaig, MD, Associate Professor in the Division of Medical Oncology at the University of Colorado Denver, commenting on the pooled analysis of RTOG 9906 and 0233 presented at the ...
Expert Point of View: Neal J. Meropol, MD
Caroline Helwick
Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, discussed the study by Kothari et al presented at the Gastrointestinal Cancers Symposium. He noted that complex interactions exist between PIK3CA and o...
Expert Point of View: Neal J. Meropol, MD
Caroline Helwick
Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Case Medical Center at Case Western Reserve University, Cleveland, discussed the various findings in RAS mutations at the Gastrointestinal Cancers Symposium. “RAS mutations beyond exon 2 are common, occurring in about 15%...
Expert Point of View: Rebecca A. Miksad, MD, MPH
Caroline Helwick
Rebecca A. Miksad, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Physician-Investigator at Beth Israel Deaconess Medical Center, Boston, who discussed the paper by Fine et al at the Gastrointestinal Cancers Symposium, said, “the study reports that a range of neuroendocrine t...
Expert Point of View: Peter Ravdin, MD
Alice Goodman
The NATAN study showed that zoledronic acid doesn’t work in that average woman in this trial [one with early breast cancer, residual tumor remaining after neoadjuvant therapy]. There is, however, a trend to modest benefit in women older than 55, which is consistent with statistically significant ben...
Expert Point of View: Jennifer R. Brown, MD, PhD
Alice Goodman
Idelalisib is being studied in three ongoing registration trials. [Study 116] was stopped early after idelalisib/rituximab demonstrated high efficacy in relapsed chronic lymphocytic leukemia [CLL],” said Jennifer R. Brown, MD, PhD, Director of the CLL Center at Dana-Farber Cancer Institute, Boston. ...
Staging of Cutaneous Squamous Cell Carcinoma
Christopher A. Barker, MD, Bhuvanesh Singh, MD, PhD, and Kishwer S. Nehal, MD
Neoplasms originating from skin keratinocytes are increasing in frequency in the United States and include a spectrum of diseases culminating in the development of invasive cutaneous squamous cell carcinoma. Although most cases of cutaneous squamous cell carcinoma can be treated conservatively with ...
How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer
In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical tr...
How to Approach the Problem of CNS Metastasis in HER2-Positive Patients
Caroline Helwick
Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer Res...
The Future of Biomedical Research
In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI), i...
City of Hope’s New Chief Scientific Officer and Cancer Center Director Reflects on His Career Path and the Future of Cancer Care
City of Hope in Duarte, California, has named Steven T. Rosen, MD, as its first Provost and Chief Scientific Officer. Dr. Rosen will guide the scientific direction of the center’s medical research, treatment, and education. He will also assume directorship of the comprehensive cancer institute, with...
Overcoming Drug Development Challenges in the New Era of Cancer Care
While the last 15 years have brought unprecedented advances in oncology drug development, the next 10 years promise to usher in even greater opportunities to realize the goal of precision medicine in the treatment of cancer, providing patients with more effective care and better outcomes. Reaching t...
Adjuvant Gefitinib in Patients With NSCLC: Bad Idea or Wrong Patient Selection?
Daniel Morgensztern, MD, and Roy S. Herbst, MD, PhD
Despite optimal surgical resection and adjuvant chemotherapy with cisplatin-based doublets, the 5-year overall survival for patients with early-stage non–small cell lung cancer (NSCLC) remains suboptimal. In the International Association for the Study of Lung Cancer (IASLC) staging project, the 5-ye...
Assessing Patients for Palliative Care
In 2012, ASCO issued a provisional clinical opinion addressing the integration of palliative care services into standard oncology practice at the time a patient is diagnosed with metastatic or advanced cancer and for patients with uncontrolled symptoms.1 However, despite ASCO’s provisional clinical ...
Oncogene Addiction and the Rationale for Molecular Targeted Therapy in Lung Cancer
Jo Cavallo
Over the past decade, Fadlo R. Khuri, MD, Professor and Roberto C. Goizueta Distinguished Chair of Hematology and Medical Oncology, and Deputy Director of the Winship Cancer Institute of Emory University, Atlanta, has focused his research and clinical career on investigating novel approaches in the ...
'Master Protocol' Could Revolutionalize Trials in Lung Cancer, and Eventually Other Cancers
Caroline Helwick
Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop ef...
New President and CEO of Fox Chase Cancer Center Reflects on Challenges and Opportunities Ahead
Ronald Piana
On October 8, 1904, a group of Philadelphia physicians and businessmen who were concerned about the escalating incidence of cancer in the city signed a charter that established the American Oncologic Hospital, one of the nation’s first hospitals solely devoted to cancer care. Seven decades later—2 y...
Comparative Effectiveness Research: Its Time Has Arrived
Ronald Piana
Reigning in the nation’s runaway medical costs was an underlying theme of President Obama’s health-care reform platform. Citing projects like The Dartmouth Atlas of Health Care, which documented large gaps in the quality, costs, and outcomes of health services around the country, the administration’...
Paging Dr. Google: Practicing Oncology in the Era of Social Media and Telemedicine
Ronald Piana
Over the past few decades, economic and political factors have reshaped oncology, especially in the community setting. To defray risk, we’ve seen a trend toward oncology practices partnering with hospitals or aggregating into larger networks. Moreover, the Internet and the advent of telemedicine hav...
What Is the Optimal Treatment of Advanced Melanoma?
Caroline Helwick
With exciting targeted and immunotherapeutic agents now part of the arsenal for metastatic melanoma, which drug should move to the head of the line? Mario Sznol, MD, Professor of Medicine at Yale University School of Medicine, New Haven, Connecticut, has been involved in key clinical trials of the n...
Undertreatment of Cancer Pain Remains a Persistent Problem in Oncology
Ronald Piana
Data indicate that for more than 2 decades, cancer pain has been undertreated in the United States. The paradox of this stubborn clinical problem is that oncology has the ability to manage the great majority of cancer pain. To clarify this issue, The ASCO Post recently spoke with nationally regarde...
The Direction of Immunotherapy Over the Next Decade
Jo Cavallo
The use of immunotherapy to target malignant cells in a variety of cancers—especially the PD-1 inhibitors lambrolizumab and nivolumab in the treatment of metastatic melanoma and the anti–PD-L1 agent MPDL3280A in the treatment of melanoma and lung, kidney, colorectal, and gastric cancers—made headlin...
The Oncologist as Author: On Guiding Patients Through Cancer
Caroline Helwick
When Tumor Is the Rumor and Cancer Is the Answer is the guidebook to cancer that Kevin P. Ryan, MD, FACP, COL, USAF (ret) wished his patients had during his 30 years of practicing oncology. The book, recently published by AuthorHouse, is an authoritative, inspiring, and even philosophical guide for ...
Combining Community Practice and Health Policy Advocacy
Ronald Piana
Barbara L. McAneny, MD, is a board-certified medical oncologist/hematologist with a robust community practice in Albuquerque, New Mexico. Dr. McAneny, who has held many leadership roles in oncology associations, became a delegate to the American Medical Association (AMA) from ASCO in 2002, was elect...
A Look Ahead: The Next Decade in Pediatric Oncology
The past 10 years have seen dramatic advances in cancer care, especially in better screening methods and earlier detection, genomic sequencing, and more effective therapies, which have led to increased survival rates in both childhood and adult cancers. According to the National Cancer Institute (NC...
Living and Working with Cancer
The most recent figures from the National Cancer Institute put the number of cancer survivors in the United States at nearly 14 million—by 2022, that number is expected to top 18 million. And for the vast majority of those survivors—more than 80%—returning to work after treatment is a top priority a...
Making the Science of Cancer Understandable to a Broad Audience
An educator and scientist for over 30 years, David Sadava, PhD, became interested in the science of cancer while on sabbatical from Claremont Colleges, where he was teaching courses in molecular biology and biotechnology, and went to the City of Hope Medical Center in Duarte, California, to study th...
Examining the Role Genetics Plays in Breast Cancer Onset
Internationally known for her research in the molecular genetics of cancer, Olufunmilayo I. Olopade, MD, FACP, first became interested in oncology during medical school in Nigeria, where she cared for patients with Burkitt’s lymphoma. After moving to Chicago in 1983 to continue her medical education...
Barriers to Successful Hematopoietic Stem Cell Transplantation
The Center for International Blood and Marrow Transplant Research is a combined research program of the National Marrow Donor Program and the Medical College of Wisconsin, Milwaukee. At the forefront of research to increase access to hematopoietic stem cell transplantation and improve outcomes, the ...
ASCO Will Change with the Times
Caroline Helwick
At the 2013 ASCO Annual Meeting, The ASCO Post caught up with new President Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center, New York, for a glimpse of his plans for ASCO in the coming year, and his thoughts on being elected ASCO President...
Treating Both the Physical and Psychological Symptoms of Cancer
A growing number of people with cancer are being treated on an outpatient basis. At the Herbert Irving Comprehensive Cancer Center of New York-Presbyterian Hospital/Columbia University Medical Center in New York, to ensure that the psychosocial and psychiatric needs of these patients were being met,...
Improving Treatment and Care for Patients with Primary Brain Cancers
Despite advances in neuroimaging, the development of focused radiation therapy, and more effective chemotherapy, life expectancy for patients with primary malignant tumors of the brain and spinal cord remains stubbornly low at between 15 and 18 months. However, there are significant advances on the ...
Caring for the Whole Patient Both during Active Treatment and at End of Life
Despite studies showing that a majority of patients prefer to die at home rather than in an institutional setting,1 in many parts of the country, over 30% die in nursing homes and over 50% die in hospitals, according to Ira Byock, MD, Director of Palliative Medicine, Dartmouth-Hitchcock Medical Cent...
Making Prevention and Early Detection of Cancer a Priority
Conquering cancer has been the goal of Bert Vogelstein, MD, since he was a teenager in Baltimore. For more than 3 decades, Dr. Vogelstein, Co-Director of the Ludwig Center for Cancer Genetics and Therapeutics and Investigator of the Howard Hughes Medical Institute at Johns Hopkins Medical Institutio...
Reducing Incidental Cardiac Irradiation during Breast Radiotherapy
Benjamin D. Smith, MD
In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of radiation...
Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates
For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University Hospita...
Women in Oncology: Trending in the Right Direction
According to ASCO President Sandra M. Swain, MD, FACP, an important part of her Presidential theme, “Building Bridges to Conquer Cancer,” is finding creative ways to ensure that we have enough oncologists to care for our burgeoning cancer patient population. Adding more women to the oncology workfo...
Disparities in Cancer Care: How A Deep South Community Overcame Them
Caroline Helwick
Racial inequities were a daily observation for Edward E. Partridge, MD, growing up in Alabama during the civil rights era. When he became a physician, he saw that these disparities extended into his own field, gynecologic oncology. He decided to do something about it. Dr. Partridge recently discusse...
Debt and the Oncology Fellow
Despite today’s challenging economy, health care is one field that offers vast career opportunities. Oncology, with the impending workforce shortage, is especially eager for bright young doctors to join its ranks. But the rising costs of medical school can be a deterrent, leading the best and bright...
A Promising New Agent's Road to Approval in CLL Raises Questions, Stirs Controversy
Early trial results in single-agent therapy with the oral Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib have produced excellent responses in patients with chronic lymphocytic leukemia (CLL). Moreover, ibrutinib is extremely well tolerated, allowing patients to remain on trial and receive the dr...
Sexual Health after Cancer: Communicating with Your Patients
Studies show virtually all cancer survivors will experience some form of sexual dysfunction following a cancer diagnosis and treatment. Yet few cancer survivors seek help for physical problems they may be experiencing, such as vaginal dryness, dyspareunia, chemically induced menopause, reduced libid...
BRAF Mutations in Colorectal Cancer: The Next Frontier
Caroline Helwick
Some 5% to 10% of patients with colorectal cancer harbor the BRAF mutation, placing them at risk for poor treatment response and worse outcomes. The ASCO Post interviewed S. Gail Eckhardt, MD, an expert in this area who is Professor and Head of the Division of Medical Oncology at the University of C...
Genomic Analysis of Squamous Cell Lung Cancer Tumors May Lead to More Targeted Therapies
Last fall, a consortium of more than 300 researchers from The Cancer Genome Atlas (TCGA) Research Network published the results of their large-scale genetic analysis of squamous cell lung cancer in the journal Nature.1 The study, the first of its kind, compared the tumor cells from 178 untreated pat...
Gene Transfer Therapy Is Producing Prolonged Remissions in Patients with Advanced Leukemia
In August 2011, researchers from the University of Pennsylvania published their breakthrough findings of a pilot study showing sustained remissions of up to 1 year in a small number of patients with advanced chronic lymphocytic leukemia (CLL) who had been treated with genetically engineered versions...
Finding New Strategies to More Effectively Treat Pancreatic Cancer
While some progress has been made in understanding the molecular pathogenesis, genetic risk factors, and genomics of pancreatic adenocarcinoma, the disease remains one of the most challenging malignancies. According to Surveillance, Epidemiology, and End Results (SEER) figures, 44,000 people were di...
Preparing for the Next Superstorm: Protecting Patients during Natural Disasters
When Hurricane Sandy slammed into the East Coast last October, the magnitude of devastation it left in its wake exceeded even the most dire predictions. Eighty mile per hour winds and record storm surges destroyed antiquated electrical grids and flooded subway stations, leaving much of New York para...
The Challenges and Rewards of Neuro-oncology
Despite the extremely difficult clinical challenges posed by brain tumors, mortality rates in this disease have decreased somewhat over the past several decades due, in part, to advances in surgical techniques and therapies. The ASCO Post recently discussed contemporary issues in neuro-oncology with...
As Computers Learn to 'Talk' to Each Other, Patient Care Will Improve
Jo Cavallo
Last fall, Edward P. Ambinder, MD, Clinical Professor of Medicine, Hematology, and Medical Oncology at the Icahn School of Medicine at Mount Sinai in New York, and a member of ASCO’s Health Information Technology Work Group, spoke about “The Information Age: Cyberspace and Cancer,” at the Chemothera...
The Doctor Who Championed Patient Navigation in Harlem
Ronald Piana
After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as one...
Treatment of HER2-positive Disease in 2013
Caroline Helwick
From the initial discovery of the HER2 family of receptors in the mid-1980s to the present, a “wealth of riches” has been uncovered in terms of agents that can target pathways relevant to this aggressive breast cancer type, notes Hope S. Rugo, MD, Director of Breast Oncology and Clinical Trials Educ...
National Comprehensive Cancer Network Appoints New CEO
Ronald Piana
The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first join...
Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills
Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...
ASCO CEO Discusses the Society’s Initiatives
Ronald Piana
Created in 1964,a the American Society of Clinical Oncology (ASCO) has become the world’s preeminent professional cancer organization, with more than 30,000 members in the United States and abroad, unified by its founders’ “common concern for the patient with cancer.” The ASCO Post recently spoke wi...
Current Perspectives on Triple-negative Breast Cancers
Caroline Helwick
Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and management....
Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?
Caroline Helwick
Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center, Hou...
How Sequestration May Affect Cancer Research
Jo Cavallo
Senator Sherrod Brown (D-Ohio) began his political career in 1974 as a state representative in Ohio. He served as Ohio’s Secretary of State between 1983 and 1991, went on to serve in the U.S. Congress from 1993 to 2006, and was elected to the Senate in 2006. A supporter of biomedical and cancer rese...
Promoting a More Balanced Approach to Cancer Prevention and Treatment
Ronald Piana
Margaret I. Cuomo, MD, is a board-certified radiologist who served for many years as an attending physician in diagnostic radiology at North Shore University Hospital, Manhasset, New York. Dr. Cuomo is the daughter of former New York Governor Mario Cuomo and sister to Governor Andrew Cuomo. She is a...
Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment
Ronald Piana
Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their inability to identify which tumors will progress and which will not has created the phenomenon of overdia...
Integrative Medicine Showing Benefits in Cancer Management
Jo Cavallo
Donald I. Abrams, MD, Chief of Hematology-Oncology at San Francisco General Hospital and Integrative Oncologist at the University of California, San Francisco, Osher Center for Integrative Medicine, has been investigating and incorporating integrative medicine approaches in his clinical treatment of...
SIDEBAR: Dacomitinib: Better in Whom? Better in What?
Tony Mok, MD
Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum of...
SIDEBAR: Dealing with the Toxicity of Everolimus/Exemestane
Caroline Helwick
While packing a punch in terms of clinical benefit, everolimus plus exemestane can also be a tough pill to swallow for many patients. The management of the potential toxicities associated with this new regimen was addressed at the 2012 Breast Cancer Symposium by Matthew J. Ellis, MB, PhD, of Washing...
Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma
Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...
The Language of Cancer
For more than a year, Don S. Dizon, MD, FACP, has been blogging at ASCO Connection (connection.asco.org) about such diverse topics as cancer survivorship, the redesign of clinical studies based on patients’ molecular characteristics, and the power of laughter. Last May, Dr. Dizon tackled the impact ...
Predictors and Treatment for Transformed Lymphoma: Current Paradigms
Ronald Piana
At the recent Pan Pacific Lymphoma Conference, held in Maui, Hawaii, Richard I. Fisher, MD, Chairman of the SWOG Lymphoma Committee and Vice-President for Strategic and Program Development at the University of Rochester Medical Center in New York, gave a presentation on the characteristics and treat...
The Science of Resilience: Exploring the Process of Grieving from a New Perspective
Jo Cavallo
How human beings cope with bereavement, loss, extreme adversity, and life-threatening illness has dominated the research interests of George A. Bonanno, PhD, Professor of Clinical Psychology, Teachers College at Columbia University, New York, for more than 20 years. In his book, The Other Side of Sa...
Rethinking the Role of PSA Screening in Public Health
Ronald Piana
Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...
Differentiated Thyroid Cancer: Who, When, and How to Treat?
Caroline Helwick
Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with adv...
Trailblazer in Argentinean Oncology Remains Optimistic about War on Cancer
Ronald Piana
Eduardo Cazap, MD, PhD, is founder and first President of the Latin American and Caribbean Society of Medical Oncology (SLACOM). In 2008, he was elected to a 2-year term as President of the International Union against Cancer (UICC). The ASCO Post recently spoke with Dr. Cazap about his roots in onco...
Information Service Provides Innovative Resource for Patients and Providers
Randi Londer Gould
Jennifer Levin Carter, MD, MPH is Founder and President of N-of-One. A board-certified internist and entrepreneur, she has more than 20 years of experience evaluating existing and emerging markets, new medical technologies, and early-stage companies in the health-care field. Formerly, Dr. Carter was...
New Study on Communicating Bad News, from the Patient’s Perspective
There is limited evidence in the literature about how oncologists should discuss bad or serious news with their patients. A recent study sought to understand what patients with cancer value when their doctors communicate news of recurrence.1 The ASCO Post spoke with the study’s lead author, Anthony ...
At More than a Century Old, American Association for Cancer Research Continues to Evolve
Barbara Boughton
Margaret Foti, PhD, MD (hc), has been Chief Executive Officer of the American Association for Cancer Research (AACR) since 1982, and has been instrumental in launching some of the most seminal efforts of the cancer research organization. Over the past 4 years, she has helped spearhead the AACR’s sci...
Multiple Myeloma Research Foundation Initiatives Are Leading to More Effective Targeted Treatment
In 1996, at just 37, the last thing Kathy Giusti expected to hear was that she had the fatal blood cancer multiple myeloma. An executive at Searle Pharmaceuticals and the mother of an 18-month-old daughter, Giusti was told she probably had 3 years to live. At the time, treatments for the disease wer...
Advances in Prostate Cancer Accompanied by Ongoing Debates
Ronald Piana
Scientific advances have markedly improved prostate cancer survival, but this clinical success story is not without its share of controversy. From screening through treatment, a growing array of options offer an admixture of promise and confusion for clinicians and patients. Moreover, today’s heated...
Managing Febrile Neutropenia: What Are the Best Antibiotic Regimens?
Management of patients with cancer who have fever and a low neutrophil count is one of the most common scenarios oncologists face today. “Physicians have to be keenly aware of the infection risks, diagnostic methods, and microbial therapies required for managing febrile neutropenic patients because ...
Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival
Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at Brookhav...
New Research Shows Promise in Cachexia, a Persistent Clinical Challenge
In the late 1980s, researchers led by Alfred L. Goldberg, PhD, first isolated the large protein complexes now called 26S proteasomes, which are the sites where most cellular proteins are degraded back to amino acids. Protein degradation by the proteasome pathway is critical in regulating many proc...
Defining Meaningful Benefit: The Debate Continues in Bevacizumab’s Wake
The events surrounding the labeling of bevacizumab (Avastin) have been well covered since last November when the FDA withdrew the drug’s accelerated approval as a treatment for metastatic breast cancer. However, the controversy initiated a debate over the value of endpoints in clinical trials in adv...
Novel Agents and Genomic Sequencing Show Promise in Improving Multiple Myeloma Management
For over 30 years, Kenneth C. Anderson, MD, Kraft Family Professor of Medicine at Harvard Medical School and Director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at Dana-Farber Cancer Institute in Boston, has focused his translational research on B-cell ...
Changing the Course of Human Health through Bold Pursuits in Science
The synergy between industry, academic research, and regulatory bodies will play an increasingly important role in ensuring the future of a robust cancer drug pipeline. To gain insight on oncologic development trends, The ASCO Post recently spoke with Jean Pierre Bizzari, MD, Head of Global Clinical...
ASCO Releases Palliative Care Provisional Clinical Opinion
ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns Hopki...
An Expert Shares Insight into the Future of Lung Cancer Treatment
Despite growing national focus on early detection, prevention, and new molecular-based treatments, lung cancer persistently remains the number 1 cause of cancer death for men and women in the United States. The ASCO Post spoke to lung cancer specialist Paul A. Bunn, Jr, MD, Executive Director, Inter...
Advances in Axillary Surgery for Patients with Breast Cancer
Caroline Helwick
Results from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial, which found no benefit for completion axillary nodal dissection in patients with breast cancer involving one to two positive sentinel nodes,1 have led to changes in breast cancer management, though points of discussio...
Searching for Quality in an Increasingly Complex Health-care Environment
With the Presidential election just around the corner, the health-care debate will undoubtedly heat up. The ASCO Post spoke with Sean R. Tunis, MD, MSc, Founder and Director, Center for Medical Technology Policy, and former Chief Medical Officer for the Centers for Medicare & Medicaid Services, ...
Research Funding Key to Continued Progress in Cancer Care
American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project Origi...
Challenges, Progress, and Future Directions in Head and Neck Cancer
Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the curren...
A Patient with Cancer Saw a Need and Left a Living Legacy
It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz Ce...
Surgical Oncology: Advances and Challenges in Breast Cancer Surgery
Ronald Piana
Mortality rates for breast cancer have declined steadily in the United States since 1990, resulting in an improvement in survival. Multiple factors have contributed to this positive trend, one of which is the combination of earlier detection and more sophisticated surgical techniques. The ASCO Post ...
Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?
Ronald Piana
Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community, but...
Advances in Gynecologic Cancer Surgery Continue to Improve Outcomes
Ronald Piana
Over the past several decades, advances in chemotherapy and surgery have begun to translate into improved survival in gynecologic malignancies. The ASCO Post recently spoke with Ginger Gardner, MD, a surgical oncologist at Memorial Sloan-Kettering Cancer Center, who specializes in the management o...
Studies Reveal that Hormonal Factors Influence Lung Cancer Risk in Women
In an effort to understand lung cancer risk factors and develop prevention strategies for the disease, Christina S. Baik, MD, MPH, thoracic oncologist and staff scientist at the Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center, has examined epidemiologic trends in lung cance...
MD Anderson Cancer Center’s New President Has a Bold Vision
Ronald Piana
On September 1, 2011, Ronald A. DePinho, MD, became only the fourth President in the 70-year history of The University of Texas MD Anderson Cancer Center in Houston. Dr. DePinho spent the previous 14 years as head of Dana-Farber’s Belfer Institute for Applied Cancer Science. In a recent interview wi...
A Conversation with Ezekiel J. Emanuel, MD, PhD
Jo Cavallo
Last September, Ezekiel J. Emanuel, MD, PhD, a leading scholar in bioethics and health-care policy, was named the Diane v.S. Levy and Robert M. Levy University Professor and Vice Provost for Global Initiatives at the University of Pennsylvania in Philadelphia. His appointment will be shared between ...
Optimizing HER2-directed Therapy in the Clinic
Caroline Helwick
Seminal research in the treatment of HER2-positive breast cancer has been led by Edith A. Perez, MD, the Serene M. and Frances C. Durling Professor of Medicine at the Mayo Clinic, Jacksonville, Florida. The ASCO Post asked Dr. Perez to share her approach to HER2-directed therapy. Testing Considerat...
Lessons from a Northern Neighbor: A Conversation with Joseph M. Connors, MD
Ronald Piana
Policy analysts searching for a better understanding of health-care models often compare the cancer delivery systems of Canada and the United States. The ASCO Post recently spoke with Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer, Vancouv...
Neural Stem Cell Transplantation May Improve Cognitive Function in Brain Cancer
Jo Cavallo
The potentially devastating long-term consequences on cognitive function in patients with brain cancer following cranial irradiation led Charles L. Limoli, PhD, Professor of Radiation Oncology, University of California, Irvine, to study neural stem cell transplantation and how the procedure may prev...
Important Lessons for Oncology from the Front Lines of the AIDS Pandemic
Ronald Piana
On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable soc...
Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?
Caroline Helwick
Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the ...
Geriatric Oncology, a Much Needed Discipline for Future Cancer Care
Ronald Piana
The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a multi...
A Conversation with Judith Redwing Keyssar, RN
Jo Cavallo
The number of patients seeking hospice and palliative care has grown significantly since 1974, when the NCI funded the first hospice facility in Branford, Connecticut. Nevertheless, according to the National Center for Health Statistics, 85% of Americans still die in hospitals or nursing homes. This...
A Conversation with Craig B. Thompson, MD
Jo Cavallo
In November 2010, Craig B. Thompson, MD, was named President and CEO of Memorial Sloan-Kettering Cancer Center (MSK) in New York, succeeding Harold Varmus, MD, who is now Director of the NCI. A cancer clinician and researcher, before coming to Memorial Sloan-Kettering Dr. Thompson was Director of th...
A Conversation with Richard J. Gilbertson, MD, PhD
Ronald Piana
St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a re...
Can Bayesian Design Streamline Our Sluggish Clinical Trial System?
Ronald Piana
The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...
Oncology Community Faces Complex Challenges in Evolving Policy Arena
Ronald Piana
As the political environment heats up in advance of the upcoming presidential campaign season, many issues crucial to the oncology community are being placed on the political chopping block as policymakers seek ways to reduce the mounting debt and soaring health-care spending. To help clarify some o...
Palliative Care, Quality of Life, and Cost
Ronald Piana
More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as a...
A Conversation with Monica Morrow, MD, FACS
Ronald Piana
Over the past 15 years, practice guidelines have become an accepted tool to help physicians optimize patient care by offering informed assessment of the benefits and potential harms associated with various care options. However, a plethora of new guidelines have entered the market, many of which suf...
Integrative Oncology Modalities Supported by Varying Levels of Evidence, but More Research Needed Overall
Ronald Piana
Over the past couple of decades, unregulated nonstandard oncology approaches have gained growing popularity among cancer patients. The relatively new field of integrative oncology was established to promote a more holistic and multidisciplinary approach to cancer care and to encourage scientific and...
Treating Cancer in Japan: A Conversation with Kensei Tobinai, MD
Ronald Piana
In this installment of Oncology Worldwide, internationally regarded lymphoma expert and cancer survivor, Kensei Tobinai, MD, Chief, National Cancer Center Hospital, Tokyo, sheds light on the Japanese oncology experience. Medical Education What was the medical school experience in Japan like? Whe...
Increased Use of Hospital Services Boosts Oncology Spending
Ronald Piana
For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of cost...
A Conversation with Samuel Silver, MD, PhD
Ronald Piana
Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO Post...
A Conversation with Constance M. Chen, MD, MPH
Jo Cavallo
Although incidence data vary widely, breast cancer–related lymphedema may affect as many as 54% of the 2.3 million survivors of breast cancer in the United States. The condition is often disabling and can result in both long-term devastating physical consequences for survivors, including the loss o...
Cancer Care in the UK: A Conversation with Chris Parker, MD
Ronald Piana
In the contentious debate over rising health-care spending, the cancer care policies of the British National Health Service (NHS) are often cited by U.S. policymakers as an example of how health-care rationing denies patients life-prolonging treatments based on costs. The ASCO Post recently spoke wi...
A Landmark Lung Screening Trial: What Does It Mean for Clinicians and Their Patients?
Ronald Piana
The NCI-funded National Lung Screening Trial (NLST), published recently in The New England Journal of Medicine,1 was heralded as a landmark study in lung cancer detection. This study is the first comprehensive clinical trial to find that screening high-risk individuals with low-dose CT reduces lung ...
NCI Clinical Investigator Team Leadership Awards: Conversations in Gynecologic Oncology
The National Cancer Institute recognized Cheryl Saenz, MD, and Linda R. Duska, MD, among others, late last year with a Cancer Clinical Investigator Team Leadership Award. The 2-year award includes $50,000 in funding for cancer research programs at NCI-designated cancer centers. The ASCO Post recentl...
A Conversation with David Henry, MD
Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical Profe...
A Conversation with Brad Zebrack, PhD, MSW, MPH
Each year in the United States, approximately 70,000 people between the ages of 15 and 40 are diagnosed with cancer. And while getting a cancer diagnosis at any age can be devastating, for adolescents and young adults (AYAs) grappling with sexuality, body image, peer pressure, dating, marriage, fami...
A Conversation with Patricia A. Ganz, MD
Researching the effects of cancer on patients’ quality of life and championing the development and implementation of survivorship care plans have been at the forefront of the 20-year-long career of Patricia A. Ganz, MD, Director of the Division of Prevention and Control Research at UCLA’s Jonsson Co...
Youssef Zeidan, MD, PhD, on HER2-Positive Breast Cancer: HERA Trial on Postmastectomy Radiation Therapy
Erica H. Bell, PhD, on Low-Grade Gliomas: Subgroup Analysis of the NRG Oncology/RTOG 9802 Trial
Nina Shah, MD: How Long Should Initial Treatment for Myeloma Last?
Lauren M. Hamel, PhD, on Race and Doctor-Patient Behavior
Tim Meyer, PhD, and Lorenza Rimassa, MD, on Advanced Hepatocellular Carcinoma: CELESTIAL Trial of Cabozantinib
