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legislation

Navigating Uncharted Waters in the Post-Chevron Sea Change

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 et ...

colorectal cancer
immunotherapy

Expert Point of View: Christopher Willett, MD

Christopher Willett, MD, Professor and Chair of the Department of Radiation Oncology at Duke University in Durham, North Carolina, shared his thoughts on the findings of the study by Lumish et al1 with The ASCO Post. He first noted the shift in recent years toward total neoadjuvant therapy in the...

lung cancer

Update on the Incidence of NSCLC: Focus on Need to Implement Widescale Screening

Recent articles in JAMA Oncology focused on lung cancer and screening strategies. Apar Kishor Ganti, MD, MS, of the University of Nebraska Medical Center, Omaha, and colleagues provided updated data on non–small cell lung cancer (NSCLC) incidence, prevalence, and stage through 2017.1 Sylvia K....

gastroesophageal cancer

Nivolumab Plus Chemotherapy Improves Survival in Advanced Gastric and Esophageal Adenocarcinomas: Now to Figure Out the Details in These Heterogeneous Diseases

There is no doubt that subsets of patients with esophageal and gastric cancers benefit from immune checkpoint inhibitor therapy. The complexity lies in identifying the appropriate histology, tumor location, expression of programmed cell death receptors and ligands, mechanism of checkpoint...

prostate cancer

TITAN Confirms Survival Benefit of Apalutamide Plus ADT in Metastatic Prostate Cancer: Now, Move Therapy Forward

As reported in the Journal of Clinical Oncology by Chi et al1—and summarized in this issue of The ASCO Post—the prespecified final overall survival analysis of the phase III TITAN trial1-3 has confirmed a clear overall survival and radiographic progression-free survival benefit with the combination ...

prostate cancer

Lutetium-177–PSMA-617: A First-in-Class Radioligand Therapeutic in Metastatic Prostate Cancer

Based on the findings of the phase III VISION trial, reported by Sartor et al1 and summarized in this issue of The ASCO Post, lutetium-177–PSMA-617 (LuPSMA) is the first of the prostate-specific membrane antigen–targeted cancer theranostics to demonstrate a survival-prolonging benefit for men with...

immunotherapy
skin cancer

Benefits of Adjuvant Pembrolizumab in Melanoma Reinforced by EORTC 1325/KEYNOTE-054 Updates

Adjuvant anti–PD-1 antibody therapy is widely used for stage III melanoma, given the approvals of pembrolizumab and nivolumab. These approvals were based on significantly improved relapse-free survival in the CheckMate 238 trial of nivolumab compared with ipilimumab and the EORTC 1325/KEYNOTE-054...

lung cancer
immunotherapy

Dual Immune Checkpoint Blockade With Nivolumab and Ipilimumab for Treatment of Malignant Pleural Mesothelioma

In recent years, immune checkpoint inhibitors in the treatment of mesothelioma have been a keen area of investigation for this immunogenic solid tumor. With recent publications, principally findings from CheckMate 743 by Baas et al1 (reviewed in this issue of The ASCO Post), combination immune...

gastroesophageal cancer

Disease-Free Survival Benefit With Adjuvant Immunotherapy in Resectable Esophageal Cancer: Practice-Changing for All Patients?

The CheckMate 577 trial—reported in The New England Journal of Medicine by Kelly et al1 and reviewed in this issue of The ASCO Post—is the first global randomized controlled trial for patients with resectable esophageal cancer that showed a significant disease-free survival benefit for adjuvant...

colorectal cancer

Expert Point of View: Michael J. Overman, MD

The study’s invited discussant, Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, said the findings of the study presented by Henriksen et al1 add to a convincing body of data showing that “the use of circulating...

leukemia

What Is the Measure of Minimal Residual Disease in AML?

Relapse is the primary obstacle to cure in leukemia. The term minimal residual disease (MRD) was coined in the early 1990s to describe finding a disease-specific marker in the context of a morphologic-appearing remission. The technique first used for MRD detection was the Southern blot (!), but the ...

breast cancer

Neratinib in Previously Treated HER2-Positive Metastatic Breast Cancer: Point of View From the NALA Trial

Neratinib is an oral pan-HER tyrosine kinase inhibitor that is approved by the U.S. Food and Drug Administration (FDA) for two indications. The first is as adjuvant treatment of early-stage HER2-positive breast cancer following adjuvant trastuzumab therapy. The second is in combination with...

Art in Oncology: How Patients Add Life to Their Days

The ASCO Post is pleased to reproduce installments of “Art of Oncology” as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer. They include narratives, topical essays, historical...

skin cancer
immunotherapy

Growing Body of Evidence Supports Adjuvant Immunotherapy for Stage IV Melanoma With No Evidence of Disease

With incredibly paced approvals and clinical advancements in the systemic therapy of cutaneous melanoma, the efficacy of immunotherapy in this disease is clear. However, many important questions remain regarding timing and dosing—in other words, which drug (or drugs) makes the most sense and in...

gynecologic cancers

Clinical Perspective on PAOLA-1: Maintenance Therapy for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both poly (ADP-ribose) polymerase (PARP) inhibitors and antiangiogenic therapies such as bevacizumab provide benefit when utilized in a maintenance strategy in the first-line treatment of advanced epithelial ovarian cancer (GOG...

breast cancer
immunotherapy

KEYNOTE-522: A Biomarker Resource for PD-1 Inhibition in Early Triple-Negative Breast Cancer

In the phase III KEYNOTE-522 trial reported in The New England Journal of Medicine and reviewed in this issue of The ASCO Post, Schmid et al1 found that the addition of pembrolizumab to neoadjuvant chemotherapy in stage II or III triple-negative breast cancer significantly improved the pathologic...

gynecologic cancers

PARP Inhibitors in Maintenance Treatment for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both PARP inhibitors and antiangiogenic therapies such as bevacizumab provide benefit when utilized in a maintenance strategy in the first-line treatment of advanced epithelial ovarian cancer (GOG 218, ICON7, SOLO-1, PRIMA,...

How Patients Add Life to Their Days

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

lymphoma

Omitting Radiation From Treatment for Early-Stage Hodgkin Lymphoma Increases Risk of Recurrence

Two presentations at the American Society for Radiation Oncology (ASTRO) Annual Meeting offered more evidence that omitting radiation therapy leads to higher rates of recurrence for patients with early-stage Hodgkin lymphoma.1,2 Both studies involve work by the German Hodgkin Study Group among...

hematologic malignancies
lymphoma

CAR T-Cell Therapy for DLBCL: At the Crossroads of Hype and Reality

In the 20-plus years I have spent in hematologic oncology, I have been fortunate to have a ringside seat to watch “game-changing” advances come into our field—all-trans retinoic acid for acute promyelocytic leukemia, tyrosine kinase inhibitors starting with imatinib for chronic myeloid leukemia,...

breast cancer
immunotherapy

IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer

THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fashion to...

Chemotherapy for Acute Myeloid Leukemia: Where Should It Be Given?

USING THE National Cancer Database, Bhatt et al1 recently reported that of the 61,775 adults with acute myeloid leukemia (AML), those who received chemotherapy from 2003 to 2011 lived longer than those who, in those same years, did not; the study is reviewed in this issue of The ASCO Post....

integrative oncology
supportive care

Mindfulness in Cancer Care: Hype or Help?

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York.   “Mindfulness” has gained significant popularity in the lay press in recent...

lung cancer

Dacomitinib vs Gefitinib in Advanced NSCLC: Improving Upon Established First-Line Targeted Therapy

THE RESULTS FROM the ARCHER 1050 study—reported by Wu et al1 and reviewed in this issue of The ASCO Post—highlight the recent optimism about improved outcomes in metastatic non–small cell lung cancer (NSCLC) harboring mutations in the epidermal growth factor receptor (EGFR) gene. This trial...

leukemia

Idelalisib in Resistant CLL: Benefit Shown, Questions Remain

As reported in The Lancet Oncology by Dr. Andrew Zelenetz and colleagues and reviewed in this issue of The ASCO Post, an international phase III trial in 416 patients with refractory or recurrent chronic lymphocytic leukemia (CLL) addressed the benefit of adding the first-in-class phosphoinositide...

cns cancers

Radiotherapy vs Temozolomide in Low-Grade Glioma: The Importance of Molecular Classification

The optimal treatment strategy for low-grade glioma has yet to be established, and practice patterns vary in regard to the timing of treatment, as well as the chosen treatment modality. It was against this backdrop, at a time when the benefits of radiation and chemotherapy remained uncertain but ...

leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

kidney cancer

Adjuvant Sunitinib for Renal Cell Carcinoma: Not Ready for Prime Time

In renal cell carcinoma and other cancer types, a consistent paradigm in drug development exists: Observe efficacy of a drug in the metastatic setting and move quickly to explore the agent in the adjuvant setting. In the cytokine era, there were multiple efforts to characterize whether adjuvant...

lymphoma

Nivolumab in Recurrent Classical Hodgkin Lymphoma: Refreshingly Supportive Data

It is commonly said that if something is too good to be true, it usually is. It is therefore quite refreshing when really good results are replicated in a subsequent study. As reported in The Lancet Oncology by Younes et al1 and reviewed in this issue of The ASCO Post, a phase II trial of...

breast cancer

Shedding Light on a Cornucopia of Breast Tumor Biomarker Assays

As our understanding of the complexities of breast cancer expands, so does our treatment armamentarium—and along with it the range of factors that must be included in our treatment decisions. Gone is the simple algorithm of adjuvant chemotherapy for almost every patient with a ≥ 2-cm tumor, except...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

Expert Point of View: Sergio Giralt, MD

Sergio Giralt, MD, Chief of Adult Bone Marrow Transplant Service at Memorial Sloan-Kettering Cancer Center, New York, commented on the findings by Papanikolaou et al presented at the 2012 ASCO Annual Meeting. “To put this trial into context, in a recent study of 283 double-refractory multiple...

Letter to the Editor: Origins of PSA Testing: The Conversation Continues

As Drs. James Mohler and Donald Trump noted in their September 15 letter to The ASCO Post (“More Thoughts on PSA,” 3[14]:2, 2012), Richard Ablin, PhD, discovered a “prostate-specific antigen” of unknown properties, but his PSA is not the antigen in the PSA test we know today. Since Dr. Ablin has...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

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...

geriatric oncology
issues in oncology

Improving the Care and Study of Older Patients with Cancer 

Predicting toxicity in older patients receiving chemotherapy is an important clinical problem. It has been shown that standard oncology measures such as performance status are not adequate to predict outcomes in the elderly. Clinical measures that are important in geriatric oncology are not...

cns cancers

Bevacizumab in Glioblastoma: Another Perspective 

Given the results of the AVAglio trial, we feel that a more balanced discussion about the role of bevacizumab (Avastin) in patients with newly diagnosed glioblastoma is in order. The accompanying article in The ASCO Post suggests that bevacizumab has no benefit in newly diagnosed glioblastoma; data ...

Expert Point of View: Ranjana Advani, MD

At the 2013 ASCO Annual Meeting, Ranjana Advani, MD, the Saul A. Rosenberg, MD, Professor of Lymphoma at Stanford University Medical Center, Palo Alto, California, discussed the promise of the B-cell signaling inhibitors idelalisib and ibrutinib in lymphoma. Biggest Question Given the...

survivorship

Making Progress in Survivorship Care Planning

The recommendation that a survivorship care plan be provided to patients and their primary care providers was first presented in the 2006 Institute of Medicine (IOM) report, From Cancer Patient to Cancer Survivor: Lost in Transition. The IOM committee proposed that this document include two parts—a ...

head and neck cancer

Adding Cetuximab to Chemoradiation Did Not Benefit Patients With Advanced Head and Neck Cancer: What Were the Reasons?

Two landmark randomized studies demonstrated improved survival of patients with head and neck cancer receiving the epidermal growth factor receptor (EGFR) antibody cetuximab (Erbitux) concurrent with radiotherapy compared with radiotherapy alone,1 and similar improvement in patients with...

Ixazomib Receives Breakthrough Therapy Designation for Relapsed or Refractory Systemic Light-Chain Amyloidosis

The U.S. Food & Drug Administration (FDA) has granted Breakthrough Therapy status to Takeda Pharmaceuticals’ investigational, oral proteasome inhibitor, ixazomib (MLN9708), for the treatment of relapsed or refractory systemic light-chain amyloidosis. This is the first proteasome inhibitor and...

hematologic malignancies

Aged to (Im)Perfection: Age-Related Clonal Hematopoiesis?

Five decades ago, the analysis of metaphase chromosomes in the hematologic malignancies provided our first broad glimpse into the genetic anatomy of a malignant cell. Today, the advent of high-throughput methods such as next-generation sequencing, capable of surveying the entire genome, provides an ...

skin cancer

The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies

The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy

An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...

skin cancer

COMBI-d Trial and the Need to Guide Progress in Melanoma Treatment

As reviewed in this issue of The ASCO Post, Long et al1 have reported the final overall survival analysis of the COMBI-d phase III trial comparing combination therapy with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) to monotherapy with dabrafenib alone,...

breast cancer

Ductal Carcinoma in Situ: Where We Have Been and Where We Can Be

Ductal carcinoma in situ has been a recent topic of debate in the news because of a recent article by Narod et al1 and an accompanying editorial2 about the study in JAMA Oncology. This study, summarized in this issue of The ASCO Post, chronicled the long-term outcomes for women diagnosed with...

breast cancer

5-Year Results of GEC-ESTRO Trial of Accelerated Partial-Breast Irradiation vs Whole-Breast Irradiation: Is There Any Impact?

There is a strong rationale for the use of accelerated partial-breast irradiation: The large majority of in-breast recurrences are at or near the primary site, limiting the radiation dose to the primary site has the potential to decrease side effects, and treatment can be delivered over a shorter...

solid tumors
prostate cancer

Decline in PSA Testing and Incidence of Early Prostate Cancer Coincide With 2012 Recommendation Against PSA Screening

Two recent studies1,2 found that the rates of prostate-specific antigen (PSA) screening have declined since the U.S. Preventive Services Task Force (USPSTF) recommended against PSA screening in 2012. One of those studies additionally found that the incidence of early-stage prostate cancer also...

Ixazomib Receives Breakthrough Therapy Designation for Relapsed or Refractory Systemic Light-Chain Amyloidosis

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy status to Takeda Pharmaceuticals’ investigational, oral proteasome inhibitor, ixazomib (MLN9708), for the treatment of relapsed or refractory systemic light-chain amyloidosis. This is the first proteasome inhibitor...

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