Perspectives
Silence Is Complicity
CORAL OLAZAGASTI, MD, AND NARJUST FLOREZ, MD, FASCO
On January 20, 2025, newly sworn-in President Donald J. Trump signed Executive Order 14151, “Ending Radical and Wasteful Government DEI Programs and Preferencing,”1 effectively eliminating all diversity, equity, and inclusion (DEI) programs, preferences, and activities across the federal governm...
Therapy With a Tyrosine Kinase Inhibitor for EGFR-Variant Lung Adenocarcinoma: Lessons From Chronic Myeloid Leukemia?
Robert Peter Gale, MD, PhD, DSc (hc), FACP, FRCP, FRCPI (hon), FRSM
There has been remarkable progress in treating EGFR-variant lung adenocarcinoma with tyrosine kinase inhibitors such as gefitinib, erlotinib, osimertinib, and afatinib. However, several important issues remain unresolved, including whether there remains a role for chemotherapy, who should receive a ...
Kindness, Mercy, Empathy, Compassion: Are They Relevant in the Era of Robotics and AI?
Raj Mohan, MS, DNB, MCh, FEBS
It’s a fast-paced world, no two ways about it. People move on from one event to another. We have to move on either for our own sake or the sake of someone near and dear. In the medical field, patients come and go, surgeries are performed, treatments are given, and everybody moves on. Being kind to ...
Mark Cuban Does It Again: Reshuffling the Deck of Front-Line CML Therapy
HAGOP M. KANTARJIAN, MD, FASCO; SHILPA PAUL, PharmD, BCOP; AND FADI G. HADDAD, MD
With the currently available BCR::ABL1 tyrosine kinase inhibitors, chronic myeloid leukemia (CML) has transformed from an invariably fatal disorder (10-year overall survival < 10%) to an indolent one, associated with a near-normal life expectancy on optimal tyrosine kinase inhibitor therapy...
Together, We’re Building a Better Future for People With Cancer and for Our Profession
ROBIN T. ZON, MD, FACP, FASCO
For more than 25 years, my goal as a community oncologist has been to ensure that all patients have access to the highest-quality cancer care. This is the future I stood for when I became ASCO’s 61st President and what I know our more than 50,000 members stand for. And I believe we will get there ...
Cancer, Aging, and Meaning: Navigating Psychosocial Challenges
Ramy Sedhom, MD
I’ve learned a lot about medicine over the years, but one thing I wasn’t taught was how to guide someone through the existential weight of dying. My education centered on diagnosing, curing, or at least managing disease—not on the delicate art of helping people and their loved ones cope with what ca...
Hyperefficient and Super-Digitized Health Care: Where Is the Smile?
CHANDRAKANTH ARE, MBBS, MBA, FSSO, FRCS, FACS
A few weeks ago, a family member underwent a minor outpatient operative procedure. From a few weeks before the scheduled date of the procedure, multiple text messages and e-mails were forwarded to provide preparatory instructions for the procedure. The day before the procedure, another confirmator...
Ageism and Its Role in the Treatment of Cancer
Sincere McMillan, DNP, MS
Age discrimination, often referred to as ageism, is an increasingly pressing issue within society. Although it can impact individuals across all age groups, older adults are particularly vulnerable. According to the U.S. Census Bureau projections, by 2040, individuals aged 65 and older will represen...
The Importance of Diversity in Clinical Research
JOHN F. SMYTH, MD
The Cancer Drug Development Forum (CDDF) held its annual conference in the Netherlands from February 3–5, 2025. Under the title “Challenges, Advances, and Open Questions in Global Cancer Drug Development and Clinical Trials,” the workshop focused on diversity and real-world evidence in anticancer cl...
Two Decades of Collaboration: The Accelerating Anticancer Agent Development and Validation (AAADV) Workshop
H. KIM LYERLY, MD, FACS; RENZO CANETTA, MD; THOMAS FLEMING, PhD; AND RICHARD L. SCHILSKY, MD, FACP, FSCT, FASCO
Over the past 20 years, the investment in research and development of cancer therapies has been unprecedented, and the pace of new drug development has been accelerating. To illustrate this trajectory, the U.S. Food and Drug Administration (FDA) approved 71 treatments for solid cancers in adults bet...
Lung-MAP 3.0: Simplifying the Process to Meet Patients’ Needs
KAREN L. RECKAMP, MD, MS
The Lung Cancer Master Protocol (Lung-MAP) is an innovative clinical trial designed to efficiently address the unmet needs of patients with advanced non–small cell lung cancer (NSCLC) following front-line therapy. This pioneering effort was the first biomarker-driven umbrella master protocol initi...
The Problem of Heterogeneity Within Stage
Murray F. Brennan, MD, and Mithat Gönen, PhD
The more senior of this duo grew up with prognostication by disease stage and was taught that all stage IV cancers behaved the same. In the past 3 decades, we have become much more cognizant of the heterogeneity in outcome within stage. Individual Kaplan-Meier plots by stage separate well but hide t...
My Cancer Diagnosis and Renewed Commitment to Fight for Patients
Ellen V. Sigal, PhD
Over 40 years ago, I lost my dear sister, Gale, to cancer. She left behind a beautiful 4-year-old daughter and a grieving family. Driven by this profound loss, I was determined to ensure that no other family would face that same heartbreak. That resoluteness led to the founding of Friends of Cance...
Is There a Role for Neoadjuvant Chemotherapy in HR-Positive, HER2-Negative Early Breast Cancer?
Kazuki Nozawa, MD
Question: Based on NATALEE and monarchE data, is there still a need for neoadjuvant chemotherapy in hormone receptor (HR)-positive, HER2-negative early breast cancer? Answer: In monarchE trial, the CDK4/6 inhibitor abemaciclib combined with endocrine therapy demonstrated long-term efficacy in pat...
Rwanda’s Progress in Eradicating Hepatitis C Virus: A Feasible Approach to Reducing Liver Cancer Incidence in Sub-Saharan Africa
DANIELLE M. THOLEY, MD, AND REGINE NSHIMIYIMANA MANIRAHO, DNP, PharmB, AOCNP
Of 58 million people worldwide living with hepatitis C virus (HCV), one-sixth of them are found in sub-Saharan Africa.1 Yet, in that region, direct access to diagnostic testing and treatment is limited to less than 5%. HCV carries significant downstream implications including cirrhosis (30%–46%)...
Could SARS–CoV-2 Be an Oncogenic Agent and Cancer Initiator?
Jo Cavallo
It’s not news that some viruses, including human papillomavirus, human immunodeficiency virus, Epstein-Barr, and hepatitis B, can cause or accelerate the development of cancer. But a recent story in The Washington Post about rare cancers being diagnosed in individuals who had previously been infecte...
Breast Cancer in 2024: Looking Back and Moving Forward
Steven Narod, MD, FRCPC
In a recent issue of The New York Times, Barron Lerner discussed Betty Ford’s breast cancer diagnosis in 1974.1 He described the state of the art of breast cancer treatment at the time and how her diagnosis accelerated the uptake of screening across the country. But her cancer was not screen-detec...
When Cancer and Cardiovascular Disease Intersect
SUSAN FAYE DENT, MD, FICOS; CHRISTINE BREZDEN-MASLEY, MD, PhD; ANNE BLAES, MD; AND BOGDA KOCZWARA, BMBS
The annual Global Cardio-Oncology Summit (GCOS) was held September 22 to 24 in Minneapolis, with 430 health-care professionals attending from 20 countries. The Summit brings together health-care professionals from diverse disciplines including members of the International Cardio-Oncology Soc...
Navigating Uncharted Waters in the Post-Chevron Sea Change
BLASE N. POLITE, MD, MPP, FASCO; MARTIN PALMERI, MD, MBA; DOMINIC SAWAYA, JD, MPPA; and REBECCA SPENCE, JD, MPH
It is not often that the oncology community looks to the Supreme Court to forecast its future. In 2024, two decisions seemingly unrelated to health care were issued that are likely to have a monumental impact on oncology care delivery. The Court’s rulings—on June 28, Loper Bright Enterprises...
The Formative Years of Medical Oncology in the United States: A Rough and Tumble Road, Part 2
VINCENT T. DEVITA, MD, AND GEORGE P. CANELLOS, MD
Medical oncology had a turbulent beginning, as we explained in part 1 of this commentary published in the September 25, 2024, issue of The ASCO Post. And although no other specialty we know of struggled as much, with perseverance and time, it had become a stable specialty of internal medicine by...
The Formative Years of Medical Oncology in the United States: A Rough and Tumble Road, Part 1
VINCENT T. DeVITA, MD, AND GEORGE P. CANELLOS, MD
Medical oncology had a turbulent beginning. No other specialty we know of struggled as much. But by 1980, it had become a stable specialty of internal medicine and was off and running—with the major problem of how to marshal available resources to freely test the myriad opportunities presented b...
IDEA Awardees’ Reflections on the 2024 ASCO Annual Meeting
the recipients of ASCO's 2024 IDEA Award (scroll down to see the complete list of authors)
It happened! We received the International Development and Education Award (IDEA) from Conquer Cancer®, the ASCO Foundation, and it was a journey of growth, global collaboration, leadership, mentorship, and more. We have much to share after this breakthrough in our careers. The ASCO Annual Meeting ...
Too Much, Too Little, Just Right: Optimizing Cancer Care for Older Adults
Ramy Sedhom, MD; Bobby Green, MD; and Julia Frydman, MD, MS
Imagine walking into a fancy restaurant only to find a menu consisting mostly of kids’ dishes. It would make no sense. Just 25% of restaurant diners are younger than age 12, and they rarely write Yelp reviews. But when it comes to cancer treatment, this is not very far from what we do. The median a...
Gift of Truth: Reflections on a Father’s Cancer Journey
Ilana Hellmann, MBBCh
It was a hot and humid Tuesday in July, and I distinctly remember being grateful for the air conditioning in the pastel-shaded waiting room of the oncology outpatient clinic. My father sat silently beside me. We knew this room well, as we did the doctor we had arrived to see. He had been my mother...
Navigating the Post-Vaccine Pandemic
Sir Murray F. Brennan, MD
By now, most health-care workers have been vaccinated against COVID-19.* Physical immunity would appear to last for at least 6 months and probably longer. The physical pandemic for most oncologists is declining, with an end in sight. We are protected from the serious physical consequences of COVID-1...
Breast Implant–Related Cancers: Should Our Patients Be Concerned?
CONNOR J. KINSLOW, MD; DAVID P. HOROWITZ, MD; AND ALFRED I. NEUGUT, MD, PhD, MPH
The U.S. Food and Drug Administration (FDA) issued a safety communication,1 which was updated2 on March 22, 2023, informing the public that there have been reports of squamous cell carcinomas (SCC) and various lymphomas of the breast in the capsule or scar of breast implants. These lymphomas a...
Cardiotoxicity: How Far Have We Come?
LORCAN RUANE, BSc, MBBS; SANDHIR PRASAD, MBBS, PhD; and JOHN ATHERTON, MBBS, PhD
A little more than 12 months ago, the first major cardio-oncology guidelines were published by the European Society of Cardiology (ESC).1 The extensive document embodied the immense progress of this subspecialty over its short existence. In reaching this milestone, it is worth considering what adva...
Accelerating Progress in Melanoma and Cancer Research
Marc Hurlbert, PhD
The Melanoma Research Alliance is on a mission to cure and prevent melanoma, a skin cancer that is diagnosed in more than 100,000 people each year and is expected to take the lives of more than 8,000 individuals in 2024.1 We invite stakeholders across all fields, including medicine, science, and ind...
Be Prepared: A Patient Perspective
I’m not prepared. It could be a few months, a few years, maybe longer. I don’t know how bad the verdict will be, but whatever it is, I’m not prepared. They always told us to be prepared. That was our motto. At age 7, I joined the Brownies, the beginning of 12 years of being molded by Girl Scout phi...
From a Small Town in Lebanon, a Young Doctor Follows His Passion to an International Career in Cancer Research
Ronald Piana
Philip A. Salem, MD, Director Emeritus of Cancer Research at St. Luke’s Episcopal Hospital, Houston, was born and reared in Bterram, a village that overlooks the Mediterranean Sea. “I had the most beautiful and blessed childhood, as I lived in a household dominated by a father who believed in the po...
AI in Cancer Care: Embrace the Change
ANANT MADABHUSHI, PhD, AND JAME ABRAHAM, MD, FACP
According to Google Chief Executive Officer Sunder Pichai, artificial intelligence (AI) is “the most profound technology humanity is working on—more profound than fire or electricity or anything that we’ve done in the past.” The impact of AI on health care and especially cancer care will not be ...
Reframing DCIS as an Opportunity for Cancer Prevention
KELLY HEWITT, MD, and LAURA J. ESSERMAN, MD, MBA, FASCO
We have been taught that early cancer detection and treatment save lives. The way to cure cancer is to find it early and treat it aggressively. The public has subscribed to this approach in our struggle to “eradicate cancer.” In certain disease types, there is merit to this philosophy. The ability t...
Treating DCIS: To Escalate or De-escalate?
Steven A. Narod, MD
There is much debate about the necessity of treating women with ductal carcinoma in situ (DCIS) with surgery or radiotherapy.1,2 It is disconcerting to many that patients with DCIS are treated in the same way as are women with early-stage invasive breast cancer. Many patients with DCIS have bilatera...
Cardio-Oncology Is a Growing Subspecialty, but Where Are the Oncologists?
Susan Faye Dent, MD, FRCPC, FIC-OS
It has been almost 20 years since the approval of trastuzumab for the treatment of early-stage, HER2-positive breast cancer. I remember returning from the 2005 ASCO Annual Meeting excited to offer patients a treatment that led to significant improvement in clinical outcomes. However, within a short ...
Sotorasib, the Poster Child for Project Optimus: Truths and Fantasies
GARTH STROHBEHN, MD, MPhil; ALLEN LICHTER, MD, FASCO; AND MARK RATAIN, MD, FASCO
In January 2021, two of us wrote in these pages about our field’s pressing need to pivot away from identifying and deploying the maximum tolerated dose (MTD) when it comes to targeted oncology therapies.1 We argued that, instead, one should be looking for the “optimal dose”—the dose that best balanc...
Generic Drug Shortages and Essential Cancer Medicines
Kevin B. Knopf, MD, MPH, and Charles L. Bennett, MD, PhD, MPP
Decisions regarding the rationing of chemotherapy are commonplace in many countries around the world—including those where patients must pay for chemotherapy out of pocket—and increasingly so in cancer settings that treat both well-off and socioeconomically disadvantaged patients. However, these lim...
EMPOWER-Lung 1 Trial: New Options, No New Answers
Apar Kishor Ganti, MD, MS
The EMPOWER-Lung 1 trial, recently reported in The Lancet and reviewed in this issue of The ASCO Post, showed an improvement in progression-free and overall survival with cemiplimab-rwlc in patients with advanced non–small cell lung cancer (NSCLC) and high PD-L1 expression (tumor proportion score [T...
All Adult Oncologists Are Geriatric Oncologists
STUART M. LICHTMAN, MD, FACP, FASCO
The data developed over the past few years have overwhelmingly favored geriatric assessment as part of the routine care for older patients with cancer. It has become the standard of care. ASCO has recently published a Practical Geriatric Assessment to aid in the implementation of this vital evaluati...
Value of Some Established Treatment Practices in Chronic Myeloid Leukemia
FADI G. HADDAD, MD, AND HAGOP M. KANTARJIAN, MD, FASCO
The introduction of imatinib mesylate, the first BCR::ABL1 tyrosine kinase inhibitor, as a treatment of Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) changed the course of the disease from invariably fatal (without allogeneic stem cell transplantation [SCT]) to indolent, where...
On Mark Cuban and the Chemotherapy Crisis
Nithya Krishnan, MD; Kimberly Boldig, DO; Kathryn Desimone, PharmD; and Ryan Rodriguez, MD
Although significant progress has been made to reduce the gap in health outcomes of minority or underserved patients, meaningful steps forward still need to be made to improve health disparities. Countless studies have shown, in general, that affluent White individuals have better health outcomes th...
Screening for Lung Cancer: Much Work Remains to Be Done
Suresh S. Ramalingam, MD, FASCO
Remarkable progress has been made in the treatment of lung cancer in the past 10 to 15 years; it is therefore not surprising that lung cancer mortality in the United States is declining consistently, at the rate of 2% to 4% annually in recent years. Long-term survival is possible even for patients w...
Gender Equity in Academic Hematology: Where There’s a ‘WiL,’ There’s a Way
ELIZA A. HAWKES, MBBS Hons, FRACP, DMedSc, AND CARLA CASULO, MD
Gender diversity, equity, and inclusion (DEI) in medicine has long been acknowledged as more than “the right thing to do,” with clear evidence of benefits in innovation, collaboration, and workplace culture.1 Yet the data continue to showcase challenges in achieving these goals despite women com...
Decentralized Care Models Empower Equitable Pediatric Cancer Treatment
NORMAN J. LACAYO, MD
Childhood Cancer Awareness Month is recognized every September to help shine a light on the realities of pediatric cancer and raise awareness of the important work being done to make a difference for the children who are diagnosed with cancer. September 15 also marked the start of Hispanic Heritage ...
The Future Priorities of the National Cancer Institute
RICHARD J. BOXER, MD, FACS
Fifty-two years ago, President Richard Nixon signed the National Cancer Act of 1971 into law, which established the National Cancer Institute (NCI) in its current form. At the time, the budget was $1.6 billion. Today, it is $7.8 billion, $4.5 billion less than the amount needed to keep up with inf...
Catalyzing Change: Young Moroccan Oncologists Spearhead the Fight Against Sarcoma
Saoussane Kharmoum, MD, PhD; Jinane Kharmoum, MD; Mariame Chraibi, MD; Mohammed Shimi, MD; and Hassan Errihani, MD, PhD
The management of sarcoma presents several challenges because of its rarity and diverse subtypes, making accurate diagnosis and specialized treatment crucial. A multidisciplinary approach involving various experts from different cancer specialties is the optimal strategy to improve survival and redu...
Perspectives on Cancer Therapy Development
William J.M. Hrushesky, MD, FACP, ABIM IM & MO
Long ago, as an ethical alternative to military service, I joined the National Cancer Institute’s Yellow Beret Program, and was assigned to its Division of Cancer Treatment (Dr. Vince DeVita) Cancer Therapy Development Branch (Dr. Steve Carter). This program reviewed and rejected or approved all exp...
Rising After Struggle: Surviving My First ASCO Breakthrough in Japan
KHALID EL BAIRI, MD
After a year of hard work preparing a strong abstract for the prestigious 2023 ASCO Annual Meeting, I finally received an acceptance letter from the scientific committee. I was overjoyed to see the efforts of our multinational team being rewarded. A few moments later, I received the decision regardi...
Shared Risk Factors for Preventing Cancer and Cardiovascular Disease: The Evolving Focus of Cardio-oncology
DAWN L. HERSHMAN, MD, MS, FASCO
Cardio-oncology represents the intersection of cancer and cardiovascular disease. Cancer therapies can result in cardiovascular complications, and some patients become less attentive to their chronic disease management after a diagnosis of cancer. As cancer patients are living longer, for some, thei...
Financial Impact of Cardiovascular Disease and Cancer Care: Overlapping Toxicities
Betty K. Hamilton, MD
The leading causes of mortality in the United States are cardiovascular disease (23%) and cancer (21%), accounting for more than 40% of total deaths reported.1,2 The increasing rise in health-care expenditures over the past several decades has driven the need for metrics to further evaluate the fina...
Cancer and War in Ukraine: How the World Can Help Win This Battle
Sergey Kozhukhov, MD, PhD; Nataliia Dovganych, MD, PhD; Ivan Smolanka, MD, PhD; Iryna Kriachok, MD, PhD; and Olexiy Kovalyov, MD, PhD
In Ukraine, with a population of about 44 million, there are more than 1.3 million patients with cancer. Approximately 160,000 new cases of cancer are diagnosed each year.1 In almost every region, there are local cancer centers; specialized oncologic centers are located in large cities. In Kyiv, hi...
