Issues in Oncology
Breast Cancer

Breast Implant–Related Cancers: Should Our Patients Be Concerned?


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?


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...

Skin Cancer

Accelerating Progress in Melanoma and Cancer Research

Marc Hurlbert, PhD  /  June 25, 2024

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...

Breast Cancer

Be Prepared: A Patient Perspective

MARY ANN DEAK  /  June 25, 2024

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  /  June 3, 2024 - Narratives Special Issue

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...

Issues in Oncology

AI in Cancer Care: Embrace the Change


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


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...

Breast Cancer

Treating DCIS: To Escalate or De-escalate?

Steven A. Narod, MD  /  April 25, 2024

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  /  March 25, 2024

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 ...

Issues in Oncology
Lung Cancer

Sotorasib, the Poster Child for Project Optimus: Truths and Fantasies


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...

Issues in Oncology

Generic Drug Shortages and Essential Cancer Medicines

Kevin B. Knopf, MD, MPH, and Charles L. Bennett, MD, PhD, MPP  /  January 25, 2024

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...

Lung Cancer

EMPOWER-Lung 1 Trial: New Options, No New Answers

Apar Kishor Ganti, MD, MS  /  May 25, 2021

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...

Issues in Oncology
Solid Tumors

All Adult Oncologists Are Geriatric Oncologists

STUART M. LICHTMAN, MD, FACP, FASCO  /  December 25, 2023

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


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...

Issues in Oncology

On Mark Cuban and the Chemotherapy Crisis

Nithya Krishnan, MD; Kimberly Boldig, DO; Kathryn Desimone, PharmD; and Ryan Rodriguez, MD  /  December 10, 2023

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...

Lung Cancer

Screening for Lung Cancer: Much Work Remains to Be Done

Suresh S. Ramalingam, MD, FASCO  /  November 10, 2023

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...

Hematologic Malignancies
Issues in Oncology

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  /  October 25, 2023

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...

Issues in Oncology

Decentralized Care Models Empower Equitable Pediatric Cancer Treatment

NORMAN J. LACAYO, MD  /  October 10, 2023

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 ...

Issues in Oncology

The Future Priorities of the National Cancer Institute

RICHARD J. BOXER, MD, FACS  /  August 25, 2023

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...

Global Cancer Care

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  /  September 25, 2023

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...

Issues in Oncology

Perspectives on Cancer Therapy Development

William J.M. Hrushesky, MD, FACP, ABIM IM & MO  /  September 10, 2023

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  /  September 10, 2023

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...

Solid Tumors

Shared Risk Factors for Preventing Cancer and Cardiovascular Disease: The Evolving Focus of Cardio-oncology

DAWN L. HERSHMAN, MD, MS, FASCO  /  May 10, 2021

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...

Issues in Oncology
Cost of Care

Financial Impact of Cardiovascular Disease and Cancer Care: Overlapping Toxicities

Betty K. Hamilton, MD  /  October 25, 2021

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...

Global Cancer Care

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  /  June 25, 2022

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...

Solid Tumors
Issues in Oncology

On the Art of Organizing Best of ASCO Meetings

NAGI S. EL SAGHIR, MD, FACP, FASCO  /  August 10, 2023

Preparing and running a medical conference is usually a complex but rewarding mission. It is a demanding job that is typically done voluntarily by physicians and educators who are dedicated to professional and community service; advancement of research and education; as well as the dissemination of ...

Issues in Oncology

‘I Want to Kill You’

Noelle K. LoConte, MD  /  July 25, 2023

My patient threatened to kill me. I was in the middle of a busy medical oncology clinic. I was seeing her to discuss test results 1 week after I told her I was concerned that her cancer had returned. As I suspected, the test confirmed recurrent cancer, and this time, it was incurable. I walked into...

Prostate Cancer

Prostate Cancer Disparities and the ‘Last Mile’ Problem

WILLIAM K. OH, MD, and CHARLES J. RYAN, MD  /  June 25, 2023

Prostate cancer is the most commonly diagnosed cancer in men in the United States and the second-leading cause of cancer death.1 It also offers a sobering example in the national conversation on racial disparities in cancer care. Despite a deeper scientific understanding of the disease—as well ...

Issues in Oncology

A Call for Tailored Medical Services in Oncology Care for Older Deaf Patients


My father is deaf. Born deaf, he is now 75 years old. He uses his voice, but he sounds strange to a hearing person when he speaks. He uses lip-reading techniques to communicate. A year ago, he was diagnosed with Hodgkin lymphoma. We did his oncology itinerary together. My father cannot go alone to m...

Issues in Oncology

Rethinking Prior Authorization


Prior authorization of medical procedures, services, and medications has been a standard requirement of health-care providers for decades. Rising health-care costs, specifically the escalating prices of cancer drug therapies, have led to a new focus by payers, providers, and policymakers on prior au...

Lung Cancer

Lung Cancer Screening and Possible Unappreciated Benefits

Ernest Hawk, MD, MPH  /  May 10, 2023

Screening that reduces cancer mortality serves as a foundational element of impactful care for certain cancers. That said, harms related to screening deserve our attention—overdiagnoses; diagnostic odysseys that may be invasive, expensive, or even unintentionally harmful; overtreatment of diagnosed ...

Multiple Myeloma

Highlighting Progress in Myeloma Treatment: POLLUX Trial Final Overall Survival Results With Daratumumab-Based Therapy

Shaji Kumar, MD  /  May 25, 2023

The updated results of the POLLUX trial, reported in the Journal of Clinical Oncology by Dimopoulos and colleagues and in this issue of The ASCO Post, showed significantly improved overall survival with daratumumab plus lenalidomide/dexamethasone (DRd) vs Rd in patients with previously treated multi...

Issues in Oncology

Partnering With Patients: The Cornerstone of Cancer Care and Research

ERIC P. WINER, MD, FASCO  /  May 25, 2023

The health and well-being of our clinicians, our communities, and our care systems need vigilance now more than ever to ensure we keep pace with the effects of change that is also advancing our medicine. When clinicians or patients talk about health care, they might mention frustrations with forms...

Gynecologic Cancers

The Role of Salpingectomy in Ovarian Cancer: Standard of Care or Targeted Therapy?

COLLEEN M. FELTMATE, MD  /  May 10, 2023

No one doubts the deadly nature of high-grade serous ovarian cancer. This histologic subtype is responsible for most ovarian cancer deaths, representing the eighth leading cause of cancer deaths in women worldwide and the fifth in the United States. Although there has been some progress in improving...

Issues in Oncology

Social Drivers of Health: Grabbing the Steering Wheel

S. MONICA SONI, MD  /  April 25, 2023

Study after study has demonstrated race-based differences in survival and other clinical outcomes for patients with cancer. But as health professionals, we are learning that these differences are less about a patient’s skin color and more about the legacy of racial inequality.1 This knowledge change...

Yes, You Should Attend the 2023 ASCO Annual Meeting

ROBERT PETER GALE, MD, PhD, DSc (hc), FACP, FRCPI (hon), FRSM  /  April 10, 2023

The questions I am challenged to answer are twofold: (1) Should you attend the 2023 ASCO Annual Meeting? (2) If you attend, how is your time best spent? Most people agree scientific conferences are important venues for cancer researchers and clinicians to share and discuss research findings, exchan...

Issues in Oncology
Global Cancer Care

It Is Time to Close the Gap in Cancer Care

Jeff Dunn, PhD, AO  /  March 25, 2023

Cancer is a leading cause of death in every country worldwide.1 In 2020, almost 10 million people died of cancer, a number that is expected to rise to 16.3 million by 2040.2 In addition, cancer incidence continues to grow, driven by an aging and growing population and changes in the prevalence and d...

Issues in Oncology

Working Together to Close the Global Care Gap


The COVID-19 pandemic has underscored that public health is the product of one global, integrated ecosystem. Although it is tempting to focus on specific aspects of local health-care systems, or the political or physical environment, health and health care in other countries also impacts the United...


Have We Reached the Limits of Chemotherapy for Burkitt Lymphoma?

Mark Roschewski, MD  /  February 25, 2023

Burkitt lymphoma (BL) is a fascinating disease from which many groundbreaking medical and oncologic lessons have been learned. Since the Irish surgeon Denis P. Burkitt, MD, FRCS, FRS, first described rapidly enlarging jaw and facial tumors in Ugandan children in 1958,1 the study of BL has led to num...

Colorectal Cancer

KRYSTAL-1 Confirms Activity of Adagrasib in KRAS G12C–Mutated Metastatic Colorectal Cancer and Highlights Need for Randomized Controlled Trials

Marwan Fakih, MD  /  February 10, 2023

KRAS G12C–mutated colorectal cancer represents 3% to 4% of metastatic colorectal cancers. Like other KRAS-mutated metastatic colorectal cancers, this group of patients represents a patient population with an unmet need, with limited options beyond two lines of therapy. In contrast to other KRAS muta...


Influence of the ‘Mark Cuban Effect’ on Cancer Drug Prices in the United States: Focus on CML

Hagop Kantarjian, MD, and Mary Alma Welch, MMSc  /  February 10, 2023

The advent of the BCR::ABL1 tyrosine kinase inhibitors for the treatment of Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) was a therapeutic miracle that changed the management paradigm of CML. The first of them, imatinib, was developed in the late 1990s.1,2 Within a few years,...

Issues in Oncology

Communicating Prognosis: A Core Competency of Patient-Centered Oncology Care

S. Monica Soni, MD, and Lowell Kleinman, MD  /  January 25, 2023

Most of us have felt our stomachs sink as we opened a patient’s radiology or laboratory report and realized the patient faced a grave situation. If we’re lucky, we have a couple of days before a scheduled patient appointment to prepare ourselves to deliver that bad news. Other times, we may have jus...

Issues in Oncology

Addressing the Continued Existence of Racial Inequities in Cancer Care

John H. Stewart IV, MD, MBA, FACS  /  January 25, 2023

The opportunity to write this commentary on cancer disparities comes at a sorrowful time for me. Despite practicing as a surgical oncologist for more than 20 years and understanding the unequal burden that cancer visits on the Black community, I was woefully unprepared for the premature death of my ...

Issues in Oncology

How Telemedicine Can Transform Clinical Research and Practice

Anne Chiang, MD, PhD, and Roy S. Herbst, MD, PhD, FACP, FASCO  /  December 25, 2022

The COVID-19 pandemic transformed the world, and nowhere more so than in the health-care arena. Significant changes happened almost overnight in the delivery of medical care to focus on the safety and convenience of patients, staff, and providers. Although pilot efforts to integrate telemedicine had...

Issues in Oncology

Cancer Drugs and Price Controls: Is It Time?


According to a recent article published in Cancer Epidemiology, Biomarkers & Prevention, cancer care in the United States exceeded $208 billion in 2020 and is expected to surpass $240 billion by 2030.1 These estimates are driven largely by a growing and aging population. The expenditures a...

Breast Cancer

Novel Selective Estrogen Receptor Degraders in Advanced Breast Cancer: Use of Elacestrant in the Phase III EMERALD Trial

Melissa McShane, MD, and Lori J. Goldstein, MD, FASCO  /  October 25, 2022

Endocrine therapy is the foundation of first-line therapy in most patients with hormone receptor–positive, HER2-negative metastatic breast cancer. Many of these patients respond to endocrine therapy but eventually become resistant to it through both intrinsic and acquired resistance mechanisms. This...

Issues in Oncology

How ASCO Is Helping Members Navigate the Cancer Care Terrain for Pregnant Patients Since the Reversal of Roe v Wade

Jo Cavallo  /  November 25, 2022

In response to the U.S. Supreme Court decision in Dobbs v Jackson Women’s Health Organization overturning Roe v Wade, eliminating the constitutional right to an abortion and returning the power to regulate reproductive health for women to the states, ASCO, the American Cancer Society Action Network,...

Colorectal Cancer

The NordICC Trial: The Devil Is in the Details

Rishi Surana, MD, PhD, and Kimmie Ng, MD, MPH  /  November 25, 2022

Colorectal cancer ranks third among cancer deaths in both men and women in the United States, with an estimated 150,000 new cases and 52,000 deaths anticipated in 2022.1 Colorectal cancer rates have declined by approximately 2% per year from 2014 to 2018 in people older than age 50, which is tho...

Issues in Oncology

My White Coat Doesn’t Fit

Narjust Florez (Duma), MD  /  November 10, 2022

There I was, crying once again all the way from the hospital’s parking lot to my apartment, into the shower, and while trying to fall asleep. This had become the norm during my internal medicine residency. For years, I tried hard every day to be someone else to fit in. It started with off-hand comme...


‘TRANSFORMING’ Our Thinking About Second-Line Therapy for High-Risk Large B-Cell Lymphoma: Bring in the CARs

Leo I. Gordon, MD, FACP  /  November 10, 2022

As reported in The Lancet by Kamdar et al,1 and summarized in this issue of The ASCO Post, the international phase III TRANSFORM trial was completed in 184 patients with primary refractory or early (≤ 12 months) relapsed large B-cell lymphoma (LBCL). Patients were randomly assigned to receive second...