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breast cancer
immunotherapy

FDA Grants Accelerated Approval to Atezolizumab/Nab-Paclitaxel; Regular Approval Contingent on Confirmatory Trials

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to atezolizumab (Tecentriq) plus nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for the treatment of adults with unresectable, locally advanced or metastatic, programmed cell death ligand 1 (PD-L1)-positive ...

integrative oncology

Omega-3 Fatty Acids

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, explore the use of omega-3 fatty acids, which have...

A Peaceful Transformation: The Origin of the Frederick National Laboratory

JUST 2 MONTHS before Congress passed what to this day is America’s most sweeping anticancer legislation, President Richard Nixon came to Fort Detrick in Frederick, Maryland, to declare his administration’s historic commitment to the fight. “I have come here today for the purpose of making an...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

hepatobiliary cancer

Cabozantinib for Hepatocellular Carcinoma Previously Treated With Sorafenib

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 14, 2019, cabozantinib was approved for the...

multiple myeloma

Reshaping the Treatment Landscape in Refractory Multiple Myeloma

THE TREATMENT approaches for multiple myeloma, both newly diagnosed and relapsed disease, continue to undergo major transformation as new agents and combinations are being introduced.1 This change has been driven by the introduction of novel drug classes such as monoclonal antibodies, as well as...

multiple myeloma

Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Patients With Multiple Myeloma

AS REPORTED in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab to pomalidomide and dexamethasone significantly prolonged...

ASH President Roy Silverstein, MD, Issues Comment on Maintenance of Certification Recommendations Draft

RECENTLY, THE American Society of Hematology (ASH) submitted feedback on draft recommendations for reforming Maintenance of Certification (MOC) to a commission appointed by the American Board of Medical Specialties (ABMS) and other entities. The “Vision Commission” released a report of its draft...

lung cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

skin cancer

New Patient Resource: NCCN Guidelines for Patients With Squamous Cell Skin Cancer

The National Comprehensive Cancer Network® (NCCN) has published a new book of patient information that explains prevention, diagnosis, and treatment for squamous cell skin cancer. Squamous cell and basal cell skin cancers are responsible for about 5 million annual incidents of nonmelanoma...

breast cancer
issues in oncology
cost of care

Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity

A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...

gynecologic cancers
issues in oncology
global cancer care

Modeling Study of Scaled-up HPV Vaccination and Cervical Cancer Screening

In a modeling study reported in The Lancet Oncology, Simms et al detailed the preventive effects on cervical cancer that could be achieved by scaled-up human papillomavirus (HPV) vaccination and cervical screening efforts with the aim of disease elimination. The major modeling projections are...

colorectal cancer

Combining Tumor Budding and Lymphocytic Infiltration May Improve Prognostic Accuracy in Colorectal Cancer

A study evaluating a prognostic signature derived from integrating tumor budding, lymphocyte infiltration, and their spatial relationship has found that the method could more accurately stratify patients with stage II colorectal cancer at high risk for disease-specific death compared with...

skin cancer
immunotherapy

A Single Dose of a PD-1 Inhibitor Before Surgery May Predict Outcomes in Patients With Melanoma

A single dose of a programmed cell death protein 1 (PD-1) inhibitor before resection for melanoma may predict clinical outcomes for patients. Researchers from the Abramson Cancer Center at the University of Pennsylvania—who documented this finding in the largest cohort of patients to be...

solid tumors
issues in oncology

Effect of Adjuvant Treatment for Early Testicular Cancer on Reproductive Potential

Men with early-stage testicular cancer can safely receive one course of adjuvant chemotherapy or radiotherapy without it having a long-term effect on their reproductive potential, according to a study published by Weibring et al in Annals of Oncology. Although it is known already that several...

leukemia

Effect of Hematopoietic Stem Cell Transplantation on Outcome in Pediatric Hypodiploid B-ALL

In a report from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology, McNeer et al found that hematopoietic stem cell transplantation (HSCT) did not improve outcomes in pediatric patients with hypodiploid B-lymphoblastic leukemia (B-ALL). Study Details The study was a...

prostate cancer

Prevalence of Adverse Germline Genetic Variants in Prostate Cancer

In a study reported in JAMA Oncology by Nicolosi et al, it was found that 17% of men with prostate cancer had likely deleterious germline genetic variants, and that many of these men would not have been considered candidates for genetic testing. Study Details The study involved data from 3,607...

gynecologic cancers

Does Lymphadenectomy Improve Survival in Advanced Ovarian Cancer?

In the international phase III LION study reported in The New England Journal of Medicine, Harter et al found that lymphadenectomy did not improve progression-free or overall survival vs no lymphadenectomy in women with advanced ovarian cancer. Study Details The trial enrolled 647 women with...

breast cancer
gynecologic cancers
hematologic malignancies
leukemia
lymphoma
symptom management

FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More

The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...

colorectal cancer
health-care policy

Effect of Affordable Care Act’s Medicaid Expansion on Colorectal Cancer Screening and Survival in Kentucky

Kentucky has been one of the most successful states in reducing its uninsured rate, which happened in part through the Affordable Care Act’s Medicaid expansion that took effect on January 1, 2014. In the past, Kentucky has reported low rates of colorectal cancer screening, and has ranked ...

skin cancer
issues in oncology

2019 AAD: Disadvantages and Potential Improvements of Artificial Intelligence in Skin Cancer Detection

While artificial intelligence (AI) systems for skin cancer detection have shown promise in research settings, there is still a lot of work to be done before the technology is appropriate for real-world use. This was the topic of a scientific session at the 2019 American Academy of Dermatology (AAD) ...

cns cancers
survivorship

Late Morbidity and Mortality in Survivors of Medulloblastoma

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Salloum et al found that changes in medulloblastoma therapy over 3 decades that have improved survival have also increased risk for subsequent neoplasms and debilitating health conditions. As noted...

lymphoma

First-Line Treatment of Indolent Non-Hodgkin Lymphoma or Mantle Cell Lymphoma With Bendamustine/Rituximab vs R-CHOP or R-CVP

As reported in the Journal of Clinical Oncology by Flinn et al, 5-year follow-up of the phase III BRIGHT trial has shown improved outcomes with first-line bendamustine/rituximab vs R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus...

issues in oncology

Eliminating the Taboo of Cancer

All homes and all families have or have had their own cancer experiences. Speaking about it dissolves the taboo and allows for earlier diagnosis, less discrimination, increased awareness, and higher commitment by authorities. It also helps those struggling with the disease feel like part of a...

issues in oncology

ASCO University Course Focuses on Fertility Preservation

Cancer can affect fertility in both men and women from adolescence through adulthood. Fertility preservation is often not addressed early enough during cancer treatment, but it should be a standard component of comprehensive care for prepubertal and reproductive-age patients. ASCO University offers ...

issues in oncology
global cancer care

Who I Am and What I Will Do

I am a radiation oncologist from Zambia, where we only have one cancer center offering radiotherapy—and I will beat cancer. This bold statement often evokes a look of surprise. However, if the conversation is allowed to go on, I’ll say cancer is beatable even where resources are thin. I am...

issues in oncology

More Than 50 Groups Sign Letter Urging HHS to Reject Proposed Changes to Medicare Part D

ASCO, along with over 50 other organizations, signed a letter from the American Cancer Society Cancer Action Network to the Department of Health and Human Services (HHS) urging the agency to reject proposed changes to Medicare Part D that could harm patient access to essential therapies, including...

hematologic malignancies

Advances in Haploidentical Transplantation and Cellular Therapies

With advances in the field, the number of haploidentical stem cell transplants being performed (ie, using human leukocyte antigen [HLA] half-matched donor stem cells) has been increasing. In recognition of evolving strategies to improve outcomes, a group of transplant physicians started the...

supportive care
palliative care

National Consensus Project Clinical Practice Guidelines: Improving Education on the Tenets of Palliative Care

The provision of palliative care (primary or specialty) is paramount to providing excellent quality care to all patients with cancer. Palliative care is associated with improving the quality of life, mood, and survival in patients with cancer. In fact, ASCO guidelines recommend that patients with...

supportive care
palliative care

National Consensus Project Releases 4th Edition of Clinical Practice Guidelines for Quality Palliative Care

As reported by Betty R. Ferrell, PhD, MA, FAAN, FPCN, of the Division of Nursing Research and Education, City of Hope Medical Center, Duarte, California, and colleagues in the Journal of Palliative Medicine, the National Consensus Project (NCP) of the National Coalition for Hospice and Palliative ...

supportive care
palliative care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

Expert Point of View: Aditya Bardia, MD, MPH

Aditya Bardia, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Director of Precision Medicine at the Center for Breast Cancer, Massachusetts General Hospital, Boston, found the PALLET study noteworthy in light of heightened interest in cyclin-dependent kinase 4/6 (CDK4/6)...

breast cancer

Neoadjuvant Palbociclib Plus Letrozole Reduces Ki67 Levels

In the neoadjuvant setting, adding palbociclib to letrozole significantly enhanced the suppression of malignant cell proliferation, as measured by Ki67 levels, in patients with primary estrogen receptor–positive breast cancer but did not increase the clinical response rate over 14 weeks, according ...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

Expert Point of View: Eleftherios (Terry) P. Mamounas, MD, William Sikov, MD, and Laura Esserman, MD

Several breast cancer experts said the findings of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis and the AERAS study are in line with data emerging from other studies of extended treatment with aromatase inhibitors. All of these studies suggest that extended...

breast cancer

Biologic Age and Elevated Breast Cancer Risk

Biologic age—a DNA-based estimate of a person’s age—may be associated with development of breast cancer, according a report published by Kresovich et al in the Journal of the National Cancer Institute. Study Methods Scientists from the National Institute of Environmental Health...

breast cancer

More Data Show Small Benefit From Extended Endocrine Therapy

Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...

Expert Point of View: Parag J. Parikh, MD

Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

Expert Point of View: Ian Davis, MBBS (Hons), PhD, FRACP, FAChPM

The formal discussant of the ARAMIS trial, Ian Davis, MBBS (Hons), PhD, FRACP, FAChPM, of Monash University and Eastern Health, Melbourne, Australia, commented: “ARAMIS is a positive trial with encouraging early results. It has a meaningful endpoint of metastasis-free survival with acceptable...

prostate cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

Expert Point of View: Robert Dreicer, MD, MS, MACP, FASCO, and Sumanta K. Pal, MD

“This is an intriguing agent,” said ASCO expert Robert Dreicer, MD, MS, MACP, FASCO, of the University of Virginia Cancer Center and moderator of a press briefing where these data were discussed. “Survival rates are low for patients with metastatic castration--resistant prostate cancer, and the...

prostate cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

Expert Point of View: Allyson Ocean, MD

Allyson Ocean, MD, a medical oncologist and attending physician in gastrointestinal oncology at NewYork–Presbyterian Hospital/Weill Cornell Medical Center, commented on the Know Your Tumor study. “This study by Pishvaian et al highlights the importance of genomics in guiding treatment decisions in ...

pancreatic cancer

Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer

Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...

kidney cancer

Pembrolizumab/Axitinib Combination Improves Outcomes vs Sunitinib in Kidney Cancer

The checkpoint inhibitor pembrolizumab plus the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor axitinib significantly improved overall survival, progression-free survival, and objective response rates vs sunitinib as first-line therapy for clear cell metastatic renal cell...

issues in oncology
survivorship

Creating ‘Right-Sized’ Follow-up Care in Oncology as Number of Cancer Survivors Grows

An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will lead to challenges in delivering care for cancer survivors in the United States if systemic changes are not made, according to a commentary in the Journal of the National Cancer...

lung cancer

Stereotactic Ablative vs Standard Radiotherapy in Inoperable Stage I NSCLC

In the phase III TROG 09.02 CHISEL trial reported in The Lancet Oncology, Ball et al found that stereotactic ablative body radiotherapy improved local disease control vs standard radiotherapy in peripherally located, inoperable stage I non–small cell lung cancer (NSCLC). The open-label trial ...

breast cancer
immunotherapy

2019 ASCO-SITC: Combination Immunotherapy for Breast Cancer With Trastuzumab and a HER2-Targeted Vaccine

After preclinical findings showed shared activity between trastuzumab and HER2-targeted vaccines, researchers evaluated adjvuant nelipepimut-S plus granulocyte-macrophage colony-stimulating factor (GM-CSF) with trastuzumab compared to trastuzumab with GM-CSF alone in patients with HER2...

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