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Endangered Art of Medicine

I hold a cold, lifeless mouse instead of my patient’s heated hand, checking off the tiny box marked “Anxiety,” while she squirms under twisted blankets.  I don’t remember when or how or why it happened, that the static screen wedged itself between my patients and me and compliance with the digital...

lymphoma

I’m Proud to Have Contributed to the FDA Approval of CAR T-Cell Therapy

When I was diagnosed with diffuse large B-cell lymphoma (DLBCL) in 2013, I used to joke that if I had to get cancer, this wasn’t a bad one to have. At just 32, I was otherwise healthy, and my prognosis for a cure was good, according to my oncologist. So I felt confident that once I underwent...

WHO Names St. Jude Its First Collaborating Center for Childhood Cancer

THE WORLD HEALTH ORGANIZATION (WHO) has designated St. Jude Children’s Research Hospital as the first WHO Collaborating Center for Childhood Cancer. With this collaboration, both organizations aim to expand efforts to develop strategies to strengthen the global resources, organization, and planning ...

lung cancer

Disparities Found in Lung Cancer Care, Survival in United States vs England

DESPITE STEADY declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Anita Andreano, MD, of the University of Milan-Ciocco, and colleagues in the Journal of Thoracic Oncology,1 Yale researchers collaborated with ...

pancreatic cancer

Actively Recruiting Clinical Trials Focused on Pancreatic Cancer

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on pancreatic cancer. These studies are investigating radiotherapy; cancer vaccines; combination treatments; novel cell therapies; response prediction; and more. All of the studies ...

issues in oncology
survivorship

Handheld Device for Detecting Heart Dysfunction in Anthracycline-Exposed Survivors of Childhood Cancer

Cardiovascular complications, such as anthracycline-related heart failure, are a leading cause of morbidity and mortality in survivors of childhood cancer, often developing at a time when these survivors are least engaged in long-term survivorship care, prompting the need for new paradigms in...

issues in oncology

Statement From FDA Commissioner on Agency Efforts to Advance the Patient Voice in Medical Product Development and Regulatory Decision-Making

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement: Over the past decade, advances in our understanding of the basic biology of serious and life-threatening diseases has led to the development and FDA approval of targeted treatments for ...

colorectal cancer
cost of care

AMA Plans Advocacy Outreach to Expand Colorectal Screening

Building on the efficacy of colorectal cancer screening, the American Medical Association (AMA) endorsed a plan at its Annual Meeting to work with physicians and payers to make the screening more available and affordable. Challenges with insurance coverage remain a barrier to colorectal cancer...

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed AML

In a study of National Cancer Database data reported in Blood Advances, Bhatt et al found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that chemotherapy is associated with a survival benefit and improvement in symptoms ...

hematologic malignancies

From Italy to Boston, A Love of Molecular Diagnostics Shapes a Career for Valentina Nardi, MD

Valentina Nardi, MD, is a staff pathologist at Massachusetts General Hospital, and her current clinical work includes implementing molecular assays for hematologic malignancies at the Center for Integrated Diagnostics. “I was born in Rome, but I did my high school and college education in Genoa. I ...

Steven A. Rosenberg, MD, PhD, Receives American College of Surgeons Jacobson Innovation Award

THE 2018 JACOBSON INNOVATION AWARD of the American College of Surgeons was recently presented to Steven A. Rosenberg, MD, PhD, Chief of the Surgery Branch at the National Cancer Institute (NCI) as well as Professor of Surgery at the Uniformed Services University of Health Sciences and at the...

palliative care

How Learning What’s on Your Patient’s Bucket List May Improve Care

It may sound too good to be true, but asking patients a simple question about what is on their bucket list can actually spark a dialogue about how best to make their cancer care and survivorship fit into their life plans, as well as be an effective way to identify their end-of-life care goals,...

ESMO Prioritizes Cancer Care at 71st World Health Assembly

AT THE 71ST World Health Assembly in Geneva, the European Society for Medical Oncology (ESMO) delivered two statements positioning cancer as a priority on the global agenda of the World Health Organization (WHO). Presenting its recommendations for action to the international community, ESMO...

issues in oncology
palliative care

Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive...

leukemia

Patients With AML Have Reduced Risk of Early Mortality at NCI-Designated Cancer Centers

RESEARCHERS AT the University of California (UC), Davis, have shown that patients with acute myeloid leukemia (AML) who received their care at a National Cancer Institute (NCI) cancer center in California had a dramatically reduced risk of early mortality. Using data from the California Cancer...

Register Today for the ASCO Research Community Forum 2018 Annual Meeting

This year’s ASCO Research Community Forum (RCF) 2018 Annual Meeting will not be one to miss! Though still a few months away, I am thrilled to share the work that is already underway to bring the research community together for 2 days of learning and collaboration. During my term as Chair of the...

issues in oncology

Resilience While Caring for Seriously Ill Patients: Skills and Strategies to Prevent Burnout

A career in oncology can be extremely rewarding. Fast-paced advances in research and treatment, exciting changes in the practice environment, and the opportunity to build strong relationships with and provide critical support to patients can be incredibly professionally satisfying—but they can...

breast cancer

Regular Mammograms Linked to Less Aggressive Treatment in Patients With Breast Cancer

A STUDY evaluating the impact of breast cancer screening has shown that the benefits of regular mammograms extend well beyond reduced mortality. According to data presented at the American Society of Breast Surgeons (ASBrS) 2018 Annual Meeting, women with breast cancer who underwent regular...

breast cancer

AJCC Breast Cancer Staging System More Clinically Relevant

THE RECENTLY issued 8th revision to the American Joint Committee on Cancer (AJCC) Breast Cancer Staging System incorporates tumor biology and prognostic stage groups and thus has become more accurate and clinically relevant, according to two speakers at the 2018 Miami Breast Cancer Conference.1,2...

solid tumors
prostate cancer

Prostate Cancer Therapy in Evolution: Time to Rethink and Redirect?

The ASCO updated guidelines on the treatment of metastatic non-castrate prostate cancer penned by Morris and his colleagues1 provide valuable information annotated to the strengths of evidence in recently reported prostate cancer studies. CHAARTED, GETUG-AFU 15, LATITUDE, and STAMPEDE have...

solid tumors
prostate cancer

De Novo Metastatic Prostate Cancer: Positive Recent News, Many Open Questions

After about 70 years with no significant progress, the landscape for men with de novo metastatic prostate cancer has changed dramatically in the past 4 years, with statistically significant and highly clinically meaningful survival improvement reported from multiple phase III trials when...

prostate cancer

DNA Test Identifies Men With Sixfold Increased Risk of Prostate Cancer

A major new study of more than 140,000 men has identified 63 new genetic variations in the DNA code that increase the risk of prostate cancer. These findings were published by Schumacher et al in Nature Genetics. Researchers devised a new test combining these single-letter genetic variants with...

issues in oncology

Parents See Cancer Prevention Potential as Best Reason for HPV Vaccination

Parents of adolescents believed that the potential to prevent certain types of cancer is the best reason for their children to receive the human papillomavirus (HPV) vaccine, whereas other reasons health-care providers often give were far less persuasive. Findings from this study were published by...

Journal of Oncology Practice Launches New Blog to Facilitate Discussions on Care Delivery Topics

The Journal of Oncology Practice (JOP) has launched a new care delivery blog, JOP DAiS (Discussion & Analysis in Short), to serve as a forum for commentary and analysis on issues affecting the mechanisms of oncology care delivery. This new platform will be a way to collaborate, debate, and...

leukemia

Activity of Ivosidenib in IDH1-Mutated Relapsed or Refractory Acute Myeloid Leukemia

As reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine by DiNardo et al, early-phase testing has shown activity of ivosidenib, an oral small-molecule inhibitor of mutant IDH1, in patients with IDH1-mutated relapsed or refractory acute myeloid leukemia (AML). IDH1...

solid tumors
prostate cancer

ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Non-castrate Prostate Cancer

As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic non-castrate prostate cancer.1 To ...

Expert Point of View: Naiyer Rizvi, MD

“In CheckMate 227, the benefit of nivolumab [Opdivo] plus ipilimumab [Yervoy] was the same in tumor mutational burden–high patients whether or not they were programmed cell death ligand 1 (PD-L1)–high or –low,” said formal discussant of this paper, Naiyer Rizvi, MD, Director of Thoracic Oncology...

solid tumors
lung cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

solid tumors
gastrointestinal cancer

Optimizing Biologics in Metastatic Colon Cancer

Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1...

hematologic malignancies
leukemia

Phase I Study Shows Safety, Efficacy of Ivosidenib in Acute Myeloid Leukemia

Ivosidenib, an isocitrate dehydrogenase-1 (IDH1) inhibitor, yielded durable and molecular remissions in some patients with IDH1-mutated advanced relapsed or refractory acute myeloid leukemia (AML). At a dose of 500 mg/d, ivosidenib was associated with a low frequency of grade 3 or higher...

solid tumors
head and neck cancer

Esomeprazole With Aspirin in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of esomeprazole with low-dose aspirin for at least 7 years may moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and may delay death from any cause in people with Barrett’s esophagus. ...

solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

Expert Point of View: Kenneth C. Anderson, MD, FASCO, Adam D. Cohen, MD, Craig Hofmeister, MD, MPH, and Bruce Cheson, MD

Kenneth C. Anderson, MD, FASCO, of Dana-Farber Cancer Institute, Boston, noted that the iNNOVATE trial is the first randomized comparison of ibrutinib (Imbruvica) plus rituximab (Rituxan) vs “a very active control—rituximab—to which 50% of patients responded.” The study showed that “the...

Expert Point of View: Andrew Epstein, MD

“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

lymphoma

EHA 2018: Tazemetostat in Relapsed or Refractory Follicular Lymphoma

Positive interim data were recently presented from an ongoing phase II study of tazemetostat—a potent, selective, orally available EZH2 inhibitor—as a monotherapy for patients with relapsed or refractory follicular lymphoma. The data, presented by Salles et al at the 23rd Annual...

solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

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 ...

hematologic malignancies

EHA 2018: Ruxolitinib Reduces Risk of Thrombosis, Death in Patients With Polycythemia Vera

A new comparison study showed that among polycythemia vera patients who were resistant or intolerant to hydroxyurea, those treated with ruxolitinib (Jakavi) had a significantly reduced risk of thrombosis and death compared to those who received best available therapy. The study findings are based...

leukemia

EHA 2018: Single-Agent Quizartinib vs Chemotherapy in Relapsed or Refractory AML

Results from the phase III QuANTUM-R study of single-agent quizartinib in relapsed or refractory acute myeloid leukemia (AML) were presented by Cortes et al at the 23rd Annual Congress of the European Hematology Association (EHA) (Abstract LB2600). Study Findings QuANTUM-R study results showed...

leukemia

EHA 2018: Undetectable MRD Rates With Venetoclax Plus Rituximab in Relapsed or Refractory CLL

Investigational data from a new analysis of undetectable minimal residual disease (MRD) rates from the phase III MURANO trial of venetoclax (Venclexta, a first-in-class oral B-cell lymphoma 2 [BCL2] inhibitor) in combination with rituximab (Rituxan) in patients with relapsed or refractory chronic...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

lymphoma
immunotherapy

EHA 2018: Tisagenlecleucel Demonstrates More Than 1-Year Durability of Response in Adults With Relapsed or Refractory DLBCL

Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...

multiple myeloma

EHA 2018: Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone vs Pomalidomide/Dexamethasone Alone in Relapsed or Refractory Multiple Myeloma

The ELOQUENT-3 trial, an international phase II study evaluating the addition of elotuzumab (Empliciti) to pomalidomide (Pomalyst) and low-dose dexamethasone in patients with relapsed/refractory multiple myeloma, achieved its primary endpoint, showing a statistically significant and clinically...

leukemia

EHA 2018: Alvocidib in Patients With Relapsed or Refractory MCL-1–Dependent AML

Preliminary data from Zella 201—an ongoing phase II study evaluating the efficacy and safety of alvocidib, a potent cyclin-dependent kinase 9 (CDK9) inhibitor, in combination with cytarabine and mitoxantrone in patients with relapsed or refractory MCL-1–dependent acute myeloid leukemia...

hepatobiliary cancer
immunotherapy

KEYNOTE-224: Pembrolizumab in Advanced Hepatocellular Carcinoma Pretreated With Sorafenib

As reported in The Lancet Oncology by Zhu et al, the phase II KEYNOTE-224 study has shown activity of pembrolizumab in advanced hepatocellular carcinoma (HCC) pretreated with sorafenib. Study Details In the study, 104 eligible patients who were intolerant of or progressed on sorafenib were...

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