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issues in oncology
cost of care
immunotherapy

Weighing the Cost and Value of CAR T-Cell Therapy

This past year’s approval by the U.S. Food and Drug Administration (FDA) of two chimeric antigen receptor (CAR) T-cell therapies heralded a new era in both effective cancer treatments and the most expensive cancer drugs ever. Tisagenlecleucel (Kymriah) was initially approved for the treatment of...

issues in oncology

Here’s How ASCO Is Joining With Other Organizations to Reduce Obesity and Cancer Rates

GUEST EDITOR Prevention in Oncology is guest edited by Jennifer A. Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber...

cns cancers
immunotherapy

Treating Pediatric Glioma With Bevacizumab and Standard Treatment

Children with nonbrainstem high-grade glioma could benefit from potentially life-extending treatment if genetic testing was used to personalize therapy as it is in many adults, new research published by Mackay et al in Cancer Cell reported.  Scientists analyzed the DNA of children taking an...

colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
kidney cancer
prostate cancer
cns cancers
leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

breast cancer
immunotherapy

For Adjuvant Trastuzumab, 6 Months Is Noninferior to 12 Months

The noninferiority phase III Persephone trial could shake up the standard of care for adjuvant trastuzumab (Herceptin), showing that patients with early-stage HER2-positive breast cancer derived as much benefit from 6 months of trastuzumab as 12 months, according to research from the United Kingdom ...

ASCO and ABIM Announce Collaboration on Maintenance of Certification Pathway

ASCO and the American Board of Internal Medicine (ABIM) have announced that they are working to co-create a pathway to provide doctors with a flexible way to maintain board certification. Beginning in 2020, oncologists will be able to choose from two different assessment pathways. They may take an ...

colorectal cancer

GAME Score for Patients With Metastatic Colorectal Cancer

Surgical oncologists at the Johns Hopkins University School of Medicine may have developed an improved scoring system for predicting survival in people with colorectal cancers that have metastasized to the liver. According to the researchers, the system, called the Genetic and Morphological...

breast cancer
immunotherapy

2018 ASCO: Shortening Adjuvant Trastuzumab to 6 Months in Patients With HER2-Positive Early Breast Cancer Is Effective and Reduces Cardiac Toxicities

Persephone, a large phase III randomized noninferiority study conducted in the United Kingdom comparing 6 months to 12 months of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer has found 6 months of trastuzumab to be noninferior to 12 months of the therapy. In addition,...

survivorship
symptom management

2018 ASCO: More Choices for Treating Insomnia in Cancer Survivors: Acupuncture and Cognitive Behavioral Therapy

A Patient-Centered Outcomes Research Institute (PCORI)-supported randomized clinical trial of cancer survivors showed that 8 weeks of either acupuncture or cognitive behavioral therapy for insomnia (CBT-I) decreased the severity of insomnia among cancer survivors, though improvements were greatest...

Thriving at Your First ASCO Annual Meeting

The ASCO Annual Meeting is the world’s largest multidisciplinary oncology conference, attracting over 30,000 attendees each year. Countless advances are unveiled in Chicago year after year. The sense of excitement generated by knowing that clinical practice may change for the bettering of our...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

gynecologic cancers
immunotherapy

Microenvironment Heterogeneity May Contribute to Lack of Immunotherapy Success in High-Grade Serous Ovarian Cancer

INTER- AND INTRAPATIENT heterogeneity of the tumor microenvironment may explain the limited success of checkpoint blockade thus far observed in patients with advanced high-grade serous ovarian cancer, according to Paulina Cybulska, MD, MSc, of Memorial Sloan Kettering Cancer Center in New York....

solid tumors
issues in oncology
symptom management

NCCN Debuts Three New Sets of Guidelines

THE NATIONAL Comprehensive Cancer Network® (NCCN®) debuted three sets of completely new guidelines for treating patients with uveal melanoma, for treating patients who have cancer and the human immunodeficiency virus (HIV), and for managing immune-related toxicities.  Cancer in People Living With...

breast cancer

Predictive Model for Breast Cancer in Women With Atypical Hyperplasia

As reported in the Journal of Clinical Oncology, Degnim et al have developed a model for predicting breast cancer risk among women with atypical hyperplasia on breast biopsy. Study Details The risk model (AH-BC) was developed using retrospective cohorts of women aged 18 to 85 years with...

breast cancer

Targeting Chemotherapy With Genetic Testing in Advanced Triple-Negative Breast Cancer

Researchers have found that women with advanced triple-negative breast cancer with a BRCA mutation were twice as likely to benefit from carboplatin as docetaxel—the current standard of care for these patients. These findings were published by Tutt et al in Nature Medicine. The trial is set...

breast cancer

Prediction of Late Distant Recurrence in Estrogen Receptor–Positive Breast Cancer After 5 Years of Endocrine Therapy

As reported in the Journal of Clinical Oncology, Dowsett et al have developed a clinicopathologic tool for predicting risk of late distant recurrence in estrogen receptor (ER)-positive breast cancer treated with 5 years of endocrine therapy. Study Details In the study, a prognostic score for...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review for Pembrolizumab Plus Pemetrexed and Platinum Chemotherapy in Metastatic Nonsquamous NSCLC

On April 30, the U.S. Food and Drug Administration (FDA) accepted for review a supplemental biologics license application (sBLA) for pembrolizumab (Keytruda) based on results of the phase III KEYNOTE-189 trial. The application seeks approval for pembrolizumab in combination with pemetrexed (Alimta) ...

gynecologic cancers
immunotherapy

Personalized Tumor Vaccine Shows Promise in Advanced Ovarian Cancer

A new type of cancer vaccine has yielded promising results in an initial clinical trial conducted at the Perelman School of Medicine at the University of Pennsylvania and the Abramson Cancer Center of the University of Pennsylvania. The personalized vaccine is made from a patient’s own immune ...

issues in oncology
global cancer care

An Inspiring Experience at Cancer Control for Primary Care Course in Bhutan

I’ll admit it. When I was first asked if I would chair the Cancer Control for Primary Care (CCPC) Course in Bhutan, I immediately exclaimed yes... and then sheepishly went to look up where exactly Bhutan was on a map. For the uninitiated, Bhutan is a country nestled between India and Tibet in the...

A Career Based on Service: Both Medical and Military

For this installment in the Living a Full Life series of articles, Edith Peterson Mitchell, MD, was interviewed by Guest Editor Jame Abraham, MD, FACP. Dr. Mitchell is Clinical Professor of Medicine and Medical Oncology in the Division of Medical Oncology at Thomas Jefferson University as well as ...

genomics/genetics

NIH Completes In-Depth Genomic Analysis

RESEARCHERS FUNDED by the National Institutes of Health (NIH) have completed a detailed genomic analysis, known as the Pan-Cancer Atlas, on a data set of molecular and clinical information from over 10,000 tumors representing 33 types of cancer.  The Pan-Cancer Atlas, published as a collection of...

Expert Point of View: Marisa Weiss, MD

At a press conference where the findings by Chlebowski et al were presented, Marisa Weiss, MD, Founder and Chief Medical Officer of Breastcancer.org and Director of Radiation Oncology at Lankenau Medical Center in Philadelphia, commended this study. “We could set a goal of losing 5 pounds for our...

AACR 2018: Prototype Assays Suggest Highly Specific Blood Test to Screen for Cancer Is Feasible

Initial findings from the Circulating Cell-Free Genome Atlas (CCGA) study showed that prototype sequencing assays tested in this analysis may facilitate the development of a highly specific blood test for early cancer detection, according to data presented at the American Association for Cancer...

breast cancer
immunotherapy

2018 Treatment Algorithm for Metastatic HER2-Positive Breast Cancer

How should clinicians position anti-HER2 agents and also incorporate endocrine therapies in the treatment of metastatic HER2-positive breast cancer? At the 2018 Miami Breast Cancer Conference, this question was explored by Sunil Verma, MD, Medical Director of the Tom Baker Cancer Center and...

sarcoma

AACR 2018: Crizotinib Yielded a High Objective Response Rate for Adult Patients With ALK-Positive Inflammatory Myofibroblastic Tumor

Among patients with inoperable, advanced, or metastatic ALK-positive inflammatory myofibroblastic tumor, 50% were confirmed to have partial or complete tumor shrinkage after treatment with the ALK-targeted anticancer therapeutic agent crizotinib (Xalkori), according to data from the phase II EORTC...

issues in oncology

NIH Completes In-Depth Genomic Analysis of 33 Cancer Types

Researchers funded by the National Institutes of Health (NIH) have completed a detailed genomic analysis, known as the Pan-Cancer Atlas, on a data set of molecular and clinical information from over 10,000 tumors representing 33 types of cancer. “This project is the culmination of more than...

lymphoma
immunotherapy

Is CAR T-Cell Therapy Setting a New Standard of Care in Lymphoma?

Data presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition on the longer-term follow-up analysis of results from the ZUMA-1 trial investigating the effectiveness of axicabtagene ciloleucel (Yescarta) in patients with refractory non-Hodgkin lymphoma (NHL) showed...

leukemia

FDA Accepts BLA for Moxetumomab Pasudotox in Hairy Cell Leukemia

On April 3, the U.S. Food and Drug Administration (FDA) accepted a Biologics License Application (BLA) for moxetumomab pasudotox, an investigational anti-CD22 recombinant immunotoxin and a potential new medicine for the treatment of adult patients with hairy cell leukemia (HCL) who have received at ...

breast cancer
immunotherapy

Potent Anti-HER2 Agents on the Horizon

THANKS TO the efficacy of five approved anti-HER2 agents, patients with HER2-positive breast cancer have overall survival numbers that are as good as, or better than, their HER2-negative counterparts. With the next generation of anti-HER2 therapies in clinical trials, these outcomes may become even ...

hematologic malignancies
lymphoma

Solid Organ Transplantation and Lymphoma

Survival of patients with Hodgkin and non-Hodgkin lymphomas is increasing, and with that comes the need, in some cases, for solid organ transplantation, often because of treatment-related toxicity. The factors involved in organ transplant among lymphoma survivors were discussed by Philip J....

Unstoppable

The following essay by Elias Jabbour, MD, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

breast cancer

EBCC-11: Women Report Fewer Side Effects With Partial or Reduced Breast Radiotherapy vs Standard WBRT

The average number of moderate or marked side effects reported by patients with breast cancer is lower if they are treated with radiotherapy to part of the breast or a reduced dose to the whole breast, rather than with standard whole breast radiotherapy (WBRT), according to new findings presented...

gynecologic cancers
immunotherapy

SGO 2018: Immunotherapy/PARP Inhibitor Combination Produces Remissions in Ovarian Cancer

A combination of the immunotherapy pembrolizumab (Keytruda) and the DNA repair–blocking agent niraparib (Zejula) can be significantly more effective than either drug alone in women with hard-to-treat ovarian cancer, a phase I/II clinical trial led by Dana-Farber Cancer Institute researchers...

cns cancers

Genomic Copy Number Aberrations and Extremely Poor Survival in High-Risk Neuroblastoma

In a study reported in the Journal of the National Cancer Institute, Depuydt et al identified two genomic copy number aberrations associated with risk of extremely poor survival in patients with high-risk neuroblastoma. Study Details The international collaborative study included normalized...

issues in oncology
survivorship

Impact of Lifestyle Choices on Outcomes in Survivors of Gastrointestinal Cancers

Physical inactivity among adult survivors of gastrointestinal cancers was tied to poor health-related quality of life, according to researchers at the American Psychosocial Oncology Society (APOS) Annual Meeting.1 Also, physical inactivity (Chi-square = 5.605, P = .018) and alcohol use (Chi-square ...

Expert Point of View: Sumanta K. Pal, MD

Over the past 12 years, “the debates in kidney cancer have gotten more exciting. Combination therapy with a programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitor is an area of intense study,” said formal discussant and ASCO Expert Sumanta K. Pal, MD, of City of...

issues in oncology

AACR 2018: Underserved Populations Lack Information About Clinical Trials, Biobanking

People in Louisiana communities with cancer health disparities would be interested in participating in clinical trials or submitting samples to biobanks if provided information about these opportunities by a trusted physician—but physicians reported lacking appropriate information to give to...

gynecologic cancers
immunotherapy

FDA Accepts Pembrolizumab sBLA for Treatment of Advanced Cervical Cancer

On March 13, Merck announced that the U.S. Food and Drug Administration (FDA) has accepted a new supplemental biologics license application (sBLA) and granted Priority Review for pembrolizumab (Keytruda), the company’s anti–programmed cell death protein 1 (PD-1) therapy. The application ...

breast cancer
issues in oncology

Breast Cancer Screening Guidelines May Lead to Delayed Diagnosis in Nonwhite Women

The current guidelines for mammographic breast cancer screening, which are based on data from primarily white populations, may lead to delayed diagnosis in nonwhite women, according to a report published by Stapleton et al in JAMA Surgery. A team of Massachusetts General Hospital (MGH)...

National Comprehensive Cancer Network Reports New Milestones, Fosters Novel Collaborations

MORE THAN 8 million copies of the National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology (NCCN Guidelines®) were downloaded in 2017, marking a 16% increase since 2016 and setting a new personal record for the NCCN. Over the past 2 years, free downloads from NCCN.org and the ...

bladder cancer

Adjuvant Chemotherapy for Upper Tract Urothelial Cancer

ADJUVANT CHEMOTHERAPY achieved robust improvements in disease-free survival and metastasis-free survival compared with surveillance in the phase III POUT study of patients with upper tract urothelial cancer.1 Further, there was an early trend toward improved overall survival with adjuvant...

colorectal cancer

Investigational Genomic Tool Identifies Consensus Molecular Subtype of Colon Tumor and May Predict Risk of Recurrence

AN INVESTIGATIONAL TOOL called ColotypeR classifies colon cancers by molecular subtype and creates a subtype-specific risk of recurrence, according to research. Developers of the tool say it will be able to guide treatment decisions. Colon cancer is highly heterogeneous in prognosis and response to ...

issues in oncology
health-care policy

Advancing Cancer Research in Challenging Times

ON OCTOBER 17, 2017, Norman E. Sharpless, MD, became the 15th Director of the National Cancer Institute (NCI), succeeding Harold E. Varmus, MD, who stepped down as Director of the agency in March 2015, and replacing Douglas R. Lowy, MD, who had served as Acting Director for 2 years. The...

breast cancer

FDA Authorizes Direct-to-Consumer Test That Reports Three Mutations in the BRCA1/BRCA2 Breast Cancer Genes

Today, the U.S. Food and Drug Administration (FDA) authorized the Personal Genome Service Genetic Health Risk (GHR) Report for BRCA1/BRCA2 (Selected Variants). It is the first direct-to-consumer (DTC) test to report on three specific BRCA1/BRCA2 breast cancer gene mutations that are most common in...

symptom management

Dexamethasone-Sparing Antiemetic Regimen in Patients Receiving Highly Emetogenic Chemotherapy

In a Japanese phase III noninferiority trial reported in the Journal of Clinical Oncology, Ito et al found that dexamethasone could be spared on days 2 and 3 in an antiemetic regimen including the neurokinin-1 (NK1) receptor antagonist aprepitant and palonosetron in patients receiving highly...

ASCO, NCCN Provide Guidance on Understanding and Managing Immunotherapy Side Effects

Immunotherapy with immune checkpoint inhibitors is the first of a new generation of immunotherapy treatments, revolutionizing treatment for many different types of cancer. By unleashing the body’s immune system to attack cancer, these treatments can send even the most hard-to-treat cancers into...

leukemia

FDA Accepts BLA for Calaspargase Pegol in Acute Lymphoblastic Leukemia

On February 28, Shire announced that the U.S. Food and Drug Administration (FDA) accepted the company’s biologics license application (BLA) for calaspargase pegol (Cal-PEG; SHP663). The investigational-stage compound is being reviewed as a component of a multiagent chemotherapeutic regimen...

Medical and Radiation Oncologists Now Able to Meet All Federal Reporting Requirements Through QOPI Reporting Registry

ASCO AND the American Society for Radiation Oncology (ASTRO) have launched their new, joint platform for quality reporting, making it easier for oncologists to comply with federal government reporting requirements in 2018. The new QOPI® Reporting Registry, a Qualified Clinical Data Registry (QCDR), ...

ASCO in Action’s New Podcast Series Addresses Critical Cancer Policy and Practice Issues

IN JANUARY 2018, ASCO launched the ASCO in Action Podcast, a new podcast series hosted by ASCO Chief Executive Officer Clifford A. Hudis, MD, FACP, FASCO. This series features thought leaders and experts in oncology discussing the most pressing policy and practice issues impacting the cancer care...

Team Wellness: Reflections From Front-Line Clinical Teams

In May 2017, I started to reflect on my own personal views of wellness and the importance of the team. Since that time, I have been fortunate to speak with members of front-line clinical teams from four different practices:  Eric Tetzlaff, MSH, PA-C, and Michael Hall, MD, MS, of Fox Chase Cancer...

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