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...

Issues in Oncology

A Call for Creativity: The Shades of Gray in Delivery of Goal-Concordant Care

S. MONICA SONI, MD  /  October 25, 2022

I continue to be struck by the creativity of medical oncologists. The reimagining of dosing, duration, or regimen composition to respond to patient symptoms or preferences is like a master chef in the kitchen. Although standardization has, with good reason, become the paragon, delivering goal-concor...


Changing the Algorithm for Relapsed or Refractory Large B-Cell Lymphomas

Sonali M. Smith, MD, FASCO  /  September 25, 2022

Despite a significant potential for cure, relapsed and refractory large B-cell lymphomas (LBCL) comprise the most common cause of lymphoma-related mortality. Sequential relapses reflect the limits of repeated exposure to chemotherapy, even when delivered at high doses. More than 30 years ago, rando...


What Is the Best Induction Regimen for Newly Diagnosed PCNSL?

Syed Ali Abutalib, MD; Arjun Patel, PharmD, BCOP; and James Rubenstein, MD, PhD  /  October 10, 2022

Primary central nervous system lymphoma (PCNSL) accounts for less than 1% of all non-Hodgkin lymphomas and between 3% and 4% of all brain tumors, with an age-adjusted incidence rate of four cases per million persons per year. Approximately 1,500 new cases are diagnosed each year in the United States...

Issues in Oncology

What the Supreme Court’s Abortion Decision Means for Patients With Cancer and Their Clinicians

Govind Persad, JD, PhD  /  September 25, 2022

On June 24, 2022, the Supreme Court ruled in Dobbs v Jackson Women’s Health Organization (Dobbs)1 and overturned Roe v Wade and Planned Parenthood v Casey, which recognized a federal constitutional right to end a pregnancy up to the point of viability. This decision opened the door for states to enf...

Issues in Oncology

EQRx Pricing Strategy: Not a Win for Everyone but a Key First Step to Expand Access to Cancer Care

Lee N. Newcomer, MD, MHA  /  September 10, 2022

EQRx is an economics professor’s dream company. It is the perfect example of the principle of substitution. EQRx provides quality, lower-cost drugs in high-cost categories that may substitute for the higher-priced options. Although the profit margin for each drug unit is smaller than the competiti...

Wall Street Doesn’t Believe in This Target

Dario C. Altieri, MD  /  September 10, 2022

March 2, 2009. Just published in the Journal of Clinical Investigation.1 And we even got the cover. Twists and turns of heat shock protein-90 (Hsp90), the chaperone, the evolutionary capacitor. Great name and important cancer target. People smiled when I talked about this at the Hsp90 conference. ...

Issues in Oncology

Impact of the Dobbs v Jackson Women’s Health Organization Ruling on Patients With Cancer

Karen E. Knudsen, MBA, PhD  /  August 25, 2022

As a nonpartisan organization, the American Cancer Society has an overarching goal to improve the lives of patients with cancer and their families. We believe all individuals should have an equitable opportunity to prevent, find, detect, and survive cancer, irrespective of geography. The June 24 de...

Issues in Oncology

Cancer Knows No Borders

Marc Lawler, PhD, FRCPath and Satish Gopal, MD, MPH  /  August 10, 2022

This is a critical time for cancer research and cancer care across the world, and the cancer community has clearly highlighted the need for greater and more equitable international collaboration. Addressing the global cancer challenge is a significant undertaking, and it has become more urgent a...

Issues in Oncology
Cost of Care

Medical Costs and Clinical Value: Playing the Long Game

M. Gregg Bloche, MD, JD; Neel U. Sukhatme, PhD, JD; And John L. Marshall, MD  /  July 25, 2022

Even as soaring medical costs strain public and private budgets around the world, patients yearn for therapeutic breakthroughs. Game-changing cancer treatments, emerging antiviral agents, and mRNA vaccines are powerful reminders of medical technology’s potential. But insurance premiums and out-of-po...

Breast Cancer

Changing the Natural History of ER-Positive, HER2-Negative Breast Cancer With the Introduction of CDK4/6 Inhibition

Richard S. Finn, MD  /  July 25, 2022

It has been 14 years since a collaboration between the University of California, Los Angeles (UCLA) and Pfizer identified a unique role for cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in estrogen receptor (ER)-positive human cell line models and demonstrated that these agents act synergistically...

Global Cancer Care

Two Early-Career Cancer Researchers From Africa Aim to Make a Difference and Never Give Up

Safa El Kefi, PhD Candidate, and Khalid El Bairi, MD  /  July 25, 2022

In countries with a high income, research in oncology is sponsored by funding agencies and industry, which has meaningfully improved survival outcomes of patients with cancer. In contrast, the African continent is disadvantaged in all aspects of human development, particularly in the fields of innov...

Issues in Oncology

Death and Clinical Trials in the Plague Years

Bruce D. Cheson, MD, FACP, FAAAS, FASCO  /  July 10, 2022

“Everybody knows that pestilences have a way of recurring in the world; yet somehow, we find it hard to believe in ones that crash down on our heads from a blue sky. There have been as many plagues as wars in history; yet always plagues and wars take people equally by surprise.” —Albert Camus, The ...

Issues in Oncology

Cautious Optimism About Mining for Patient-Centric Data

Robert Peter Gale, MD, PhD, DSc (hc), FACP, FRCPI (hon), FRSM  /  July 10, 2022

“If we have data, let’s look at it. If all we have are opinions, let’s go with mine.” —James Barksdale  In this issue of The ASCO Post, Daniel Vorobiof, MD, and Irad Deutsch, principles at Belong.Life, a patient-oriented website whose self-described mission is to improve patient quality of life an...

Issues in Oncology

Shaping the Future of Cancer Care: The Value of Managing Aggregated Data From Patients’ Online Communities

Daniel Vorobiof, MD, and Irad Deutsch  /  July 10, 2022

In 2021, more than 1.9 million people in the United States were estimated to be diagnosed with cancer, and that number continues to increase yearly. Medical research is critical in prolonging survival and improving the quantity and quality of life of patients. Cancer research is one of the most heav...

Gynecologic Cancers

ARIEL4 Confirms Rucaparib’s Efficacy in Recurrent, BRCA-Mutated Ovarian Cancer: Does It Tell Us Anything New?

Kathleen Moore, MD, MS  /  June 25, 2022

In March 2022, Kristeleit et al reported the results of the ARIEL4 trial1 of rucaparib in relapsed BRCA-mutant ovarian cancer in The Lancet Oncology (summarized in this issue of The ASCO Post) and are to be congratulated on this accomplishment. This report, along with the almost simultaneous release...

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...

Issues in Oncology

Invest in the Unexpected: Basic Research Enterprise Needs Adequate Funding to Foster Treatment Innovation

Ronald DePinho, MD  /  June 25, 2022

The National Institutes of Health (NIH) now stands as the largest single public funder of biomedical research in the world.1 The FY2022 Consolidated Appropriations Act (H.R. 2471), signed into law in March, increases biomedical research funding by nearly 5%, and it provides a total of $45 billion fo...

Gastroesophageal Cancer

PD-1 Inhibition in First-Line Treatment of Advanced Esophageal Squamous Cell Carcinoma: More to Come on New Paradigm

Jill Lacy, MD, and Michael Cecchini, MD  /  May 25, 2022

Esophageal cancer is associated with significant morbidity and mortality worldwide, with more than 600,000 new cases and 540,000 deaths in 2020. The squamous cell histology comprises nearly 90% of cases globally, despite its steady decline in the United States over the past 40 years. Historically, t...

Global Cancer Care

Annual Meeting of the Moroccan Cancer Society: An Opportunity for Young Cancer Researchers to Evolve

Khalid El Bairi, MD; Dounia Filali, MD; Nabil Ismaili, MD; Zouhour Bourhaleb, MD; Ali Sbai, MD; Mohamed Marjani, MD; Zineb Benbrahim, MD; Meriem Iraqi Houssaini, MD; and Mohamed Mesmoudi, MD; On Behalf Of The Moroccan Cancer Society  /  June 10, 2022

The Moroccan Cancer Society (MCS; Société Marocaine de Cancérologie/ was created in 1992 by a group of Moroccan medical and radiation oncologists, surgeons, and pathologists who had led the field in the 1980s. To date, this scientific society has more than 350 members practicing in bo...

Cemiplimab-rwlc Following Platinum-Based Chemotherapy in Recurrent or Metastatic Cervical Cancer: Clinical Implications

Renata R. Urban, MD  /  June 10, 2022

It is estimated that globally, more than 600,000 women per year are diagnosed with cervical cancer, and more than 300,000 die annually of the disease.1 Many women continue to be diagnosed with cervical cancer at an advanced stage, with a high risk of recurrence. To date, the most effective combinat...

Breast Cancer

DESTINY-Breast03: Should Trastuzumab Deruxtecan Be the Preferred Second-Line Regimen in HER2-Positive Metastatic Breast Cancer?

Nancy U. Lin, MD  /  June 10, 2022

Since the introduction of trastuzumab in the late 1990s, overall survival for patients with HER2-positive metastatic breast cancer has substantially improved. Median overall survival in the pivotal first-line trial was only 20.3 months in the chemotherapy arm, and 25.1 months in the trastuzumab/chem...

Breast Cancer

No Good Treatment Options, So I’ll Eat Ice Cream

Mary Evelyn Burman, PhD, MS, BSN  /  June 10, 2022

On a warm summer afternoon, I stood in front of tables at the local farmers market loaded with my favorite fruits and vegetables: peaches, tomatoes, corn, peppers, melons, kale. I practically drooled thinking about what I could make that week: corn and tomato salad, kale and mushroom quesadillas, ch...

Geriatric Oncology

Missed Opportunities in Geriatric Oncology Research

Stuart M. Lichtman, MD, FACP, FASCO  /  June 3, 2022 - Narratives Special Issue

The underrepresentation of older patients (≥ 65 years) in clinical trials has been well documented for more than 20 years. This has been an issue at all phases of drug development, including pivotal trials for drug approvals,1 despite the fact that many of these new therapeutics will primarily be us...

Skin Cancer

RELATIVITY-047: Relatlimab Plus Nivolumab Worthy of Further Study in Advanced Melanoma and Beyond

James W. Smithy, MD, MHS, and Margaret K. Callahan, MD, PhD  /  April 10, 2022

In the recently published results of the RELATIVITY-047 trial,1 summarized in this issue of The ASCO Post, the addition of relatlimab to nivolumab monotherapy was associated with improved progression-free survival compared with nivolumab alone in patients with previously untreated advanced, unre...

Issues in Oncology

Incidental Respiratory Disease Found in Low-Dose CT Screens: Challenges and Opportunities

Ryan Nguyen, DO, Lawrence E. Feldman, MD, and Mary M. Pasquinelli, DNP, FNP-BC  /  May 25, 2022

A retrospective analysis of the National Lung Screening Trial (NLST) by Pinsky et al, summarized in the April 25, 2022, issue of The ASCO Post, found high rates of incidental respiratory abnormalities on low-dose computed tomography (CT) examinations.1 Specifically, the findings of emphysema and ret...

Issues in Oncology

Innovation Can Advance Equitable Cancer Care

Everett Vokes, MD, FASCO  /  May 25, 2022

The North Star of an organization is its mission statement. At ASCO, no initiative gets the green light unless it can fulfill the Society’s mission. ASCO updated its mission statement in 2020 specifically to reinforce our goal of reducing disparities, changing it to read: “Conquering cancer through ...

Lung Cancer

Long-Term Overall Survival in Unresectable Stage III NSCLC With Consolidation Durvalumab in the PACIFIC Trial: Translation to Real-World Outcomes?

Manali I. Patel, MD, MPH, MS  /  May 25, 2022

Lung cancer mortality rates have declined by more than 50% in men since 1990 and more than 30% in women since 2002. These declines in mortality are largely due to increases in smoking cessation. However, in recent years, clinical treatment advances, such as targeted therapies and immunotherapy, have...

Issues in Oncology

The Impact of War on Patients With Cancer

Jo Cavallo  /  May 25, 2022

Just days after Russia invaded Ukraine on February 24, ASCO, together with its partners the American Cancer Society (ACS) and the Sidney Kimmel Cancer Center–Jefferson Health, began assembling resources to establish a network of oncology professionals to help Ukrainian patients with cancer find clin...

Lung Cancer

DESTINY-Lung01: Is Trastuzumab Deruxtecan the Answer for HER2-Mutant Lung Cancer?

Ibiayi Dagogo-Jack, MD  /  May 10, 2022

The human epidermal growth factor (HER) family of receptors are a well-established therapeutic target. Indeed, seminal studies conducted nearly 2 decades ago identified a key association between activating mutations in the kinase domain of the epidermal growth factor receptor (EGFR, also known as HE...

Multiple Myeloma

Going the Last Mile: Accelerating Delivery of Multiple Myeloma Therapies to All Patients

Kathy Giusti, MBA  /  May 10, 2022

When I was diagnosed with multiple myeloma in 1996, I was given 3 years to live. At the time, there was little understanding of this disease, which was termed incurable. There were no new treatments, few drugs in the pipeline, hardly any clinical trials, and no multiple myeloma community or ecosys...

Breast Cancer

Immune Checkpoint Inhibitors in Neoadjuvant or Adjuvant Therapy for Triple-Negative Breast Cancer: The Paradigm Shifts

Lisa A. Carey, MD, ScM, FASCO  /  April 25, 2022

The “holy grail” of triple-negative breast cancer therapy has been effective incorporation of drugs to improve outcomes in the early nonmetastatic setting. Although outcomes have improved with better chemotherapy drugs and schedules, triple-negative breast cancer still carries the worst prognosis of...

Issues in Oncology

Phase III Trials and Tribulations

Louis M. Staudt, MD, PhD, and Wyndham H. Wilson, MD, PhD  /  April 25, 2022

Imagine this. You are a large pharmaceutical company that launches an international randomized phase III trial to assess whether one of your drugs improves the outcome of patients with a common type of cancer. The trial was solidly backed by preclinical evidence that the drug target was essentia...

Gynecologic Cancers

MEK Inhibition Is Now a Standard of Care in Recurrent Low-Grade Serous Ovarian Cancer: What Next?

Rachel N. Grisham, MD  /  April 25, 2022

As summarized in this issue of The ASCO Post, the highly anticipated results of the GOG 281/LOGS study, which randomly assigned patients with recurrent low-grade serous ovarian cancer to the MEK inhibitor trametinib vs standard-of-care chemotherapy or endocrine therapy, have now been reported by G...

Issues in Oncology

Reflections on the Evolution of Clinical Care Since the Passage of the National Cancer Act of 1971

Neal J. Meropol, MD, FASCO  /  April 10, 2022

Recently, I had the honor of coauthoring a chapter with Eric P. Winer, MD, President-Elect of ASCO, on the evolution of clinical cancer care since the enactment of the National Care Act of 1971 for the book A New Deal for Cancer: Lessons From a 50-Year War, by Abbe R. Gluck and Charles S. Fuchs, M...

Kidney Cancer

Deciphering Clinical Outcomes Through Molecular Profiling: The IMmotion151 Trial


Over the past decade, an improved understanding of kidney cancer biology together with the development of novel systemic therapies have substantially improved the outcomes of patients with metastatic clear cell renal cell carcinoma (RCC).1 Following extensive clinical investigations, combinations of...

Solid Tumors

Should Patients Aged 80 and Older Receive Single-Agent Immune Checkpoint Inhibitor Treatment?

STUART M. LICHTMAN, MD, FACP, FASCO  /  March 25, 2022

The checkpoint inhibitors are among the most important advances in oncology in recent times. They have changed the natural history of many tumors, particularly melanoma. They have a favorable toxicity profile, which for most patients is manageable and tolerable. However, there are several toxicities...