Expert’s Corner
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 ...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
Past CMS and FDA Head Discusses Challenges in U.S. Health-Care Policy and Possible Solutions
Ronald Piana
As evidenced at this year’s ASCO20 Virtual Scientific Program, oncology science, technology, and clinical practice are evolving at a rapid pace, bringing new challenges to the efficient and ethical practice of cancer care at all levels. To shed light on some of the large-scale public health and po...
Redefining What It Means to Have Precursor Myeloma
Jo Cavallo
Studies have shown that all patients diagnosed with multiple myeloma had a preceding asymptomatic expansion of clonal plasma cells, clinically recognized as monoclonal gammopathy of undetermined significance or smoldering multiple myeloma. According to C. Ola Landgren, MD, PhD, Professor of Medicine...
Challenging the Global Community to Deliver Equitable Cancer Care for All
Jo Cavallo
For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when her...
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...
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...
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...
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 ...
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...
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...
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 ...
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...
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...
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 ...
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 ...
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...
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...
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 ...
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...
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...
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 ...
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, ...
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 ...
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...
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...
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...
Overcoming the Challenges of Presenting the ASCO Annual Meeting During the COVID-19 Pandemic
As the worldwide cases of the coronavirus started to mount in February and March, medical societies and organizations monitoring the escalating COVID-19 pandemic and its impact on international and domestic travel made the difficult decision to postpone or cancel their scientific conferences. On Mar...
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...
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...
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 ...
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...
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...
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...
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...
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 ...
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 (...
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...
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....
