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issues in oncology

2019 Physician Fee Schedule and Quality Payment Program Proposed Rules Released

The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for 2019 Medicare physician reimbursement.  CMS estimates that in 2019, the overall impact for the hematology/oncology specialty will be a 4% reduction in reimbursement and a 2% reimbursement reduction for...

hematologic malignancies
multiple myeloma

New Tool for Assessing Frailty Predicts Survival in Newly Diagnosed Multiple Myeloma

A new frailty index predicts overall survival for patients newly diagnosed with multiple myeloma, according to a study recently published in JCO Clinical Cancer Informatics (JCO CCI). This tool is important because frailty is a critical factor in treatment decision-making for many patients with...

Breast Cancer Surgeon Hannah Hazard-Jenkins, MD, Deftly Balances Career and Family

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with breast cancer surgeon...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Newly Diagnosed Transplant-Ineligible Multiple Myeloma

In May 2018, daratumumab (Darzalex) was approved for use in combination with VMP (bortezomib, melphalan, and prednisone) in the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1 Supporting Efficacy Data Approval was based on...

issues in oncology

Obesity and Cancer: Complex Interplay of Multiple Factors

The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...

Be Prepared to Assist Patients to Make Informed Decisions About Breast Reconstruction Options

Two studies about postmastectomy breast reconstruction were recently published in JAMA Surgery. One study found overall complication rates of 32.9% at 2 years after reconstruction, with women having autologous reconstruction more likely to have complications than those having implant...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

pain management

Expert Point of View: Ian Olver, AM, MD, PhD

Though many case studies and anecdotal reports have touted the effectiveness of cannabinoids for cancer pain, in randomized studies, the areas in which they are effective are “fairly borderline,” according to Ian Olver, AM, MD, PhD, Immediate Past President of the Multinational Association of...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

issues in oncology

Stakeholders Agree: ‘Value’ in Cancer Care Depends on Perspective

In a roundtable discussion moderated by Clifford Goodman, PhD, of The Lewin Group, Falls Church, Virginia, representatives of the patient advocacy community, public and private payers, large and small clinics, and the pharmaceutical industry did not always see eye to eye on what “value” means nor ...

hematologic malignancies
lymphoma

FDA Approves Mogamulizumab-kpkc for Two Rare Types of Non-Hodgkin Lymphoma

On August 8, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use in the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...

lymphoma

Venetoclax and Beyond: Successfully Targeting BCL2

Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...

issues in oncology

Medical Marijuana: Research Not Anecdotes

For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...

lung cancer
issues in oncology

Small Study Looks at Physician-Patient Discussions About Lung Cancer Screening

National guidelines advise doctors to discuss the benefits and harms of lung cancer screening with high-risk patients. A small study (n = 14) by researchers from the University of North Carolina Lineberger Comprehensive Cancer Center reported there is a gap between what guidelines...

issues in oncology

Unraveling the Mystery of What Gives Exceptional Responders Their Superpower

Once dismissed as rare medical miracles that overcame overwhelming odds to thwart cancer, exceptional responders to cancer treatment are now the subject of intense study. In 2015, the National Cancer Institute (NCI) announced the launch of its Exceptional Responders Initiative, with the goal of...

lymphoma
immunotherapy

For Hodgkin Lymphoma, PD-1 Blockade Is Not the Final Answer

Although programmed cell death protein 1 (PD-1) blockade is highly effective in Hodgkin lymphoma, not all patients respond, and not all responses are durable. Stephen M. Ansell, MD, PhD, Chair of the Mayo Clinic Lymphoma Group and Professor of Medicine at the Mayo Clinic, Rochester, described...

skin cancer

Basal Cell Carcinoma and Risk for Development of Other Cancers

Patients who develop frequent cases of basal cell carcinoma appear to be at significantly increased risk for the development of other cancers, according to a study published by Cho et al in JCI Insight. Methods Researchers studied 61 people treated at Stanford Health Care for frequent...

multiple myeloma

Drug Combination Design for Multiple Myeloma Using an AI Platform

A multidisciplinary team of researchers from the National University of Singapore (NUS) has developed an artificial intelligence (AI) technology platform that could potentially change the way drug combinations are being designed, hence enabling doctors to determine the most effective drug...

breast cancer

FDA Grants Clearance of PowerLook Density Assessment for Digital Breast Tomosynthesis

iCAD has announced U.S. Food and Drug Administration (FDA) clearance of its artificial intelligence software program, PowerLook Density Assessment Version 3.4, which provides an automated method of determining breast density. The software is compatible with iCAD’s digital breast...

gynecologic cancers

Definitive Pelvic Radiation Therapy Plus Chemotherapy and Survival in Newly Diagnosed Metastatic Cervical Cancer

In a study using National Cancer Database data reported in JAMA Oncology, Wang et al found that definitive pelvic radiation therapy plus chemotherapy was associated with improved survival vs chemotherapy alone in newly diagnosed metastatic cervical cancer. The study included data from 3,169...

breast cancer
issues in oncology

Cardiac Monitoring in Patients With Breast Cancer

Although heart failure is an uncommon complication of breast cancer treatment, the risk may be higher in patients treated with certain types of chemotherapy and lower in younger patients, according to a study published by Henry et al in JACC: Cardiovascular Imaging. Researchers studied 16,456...

colorectal cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Encorafenib Plus Binimetinib and Cetuximab in BRAF V600E–Mutant Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for encorafenib (Braftovi) in combination with binimetinib (Mektovi) and cetuximab (Erbitux) for the treatment of patients with BRAF V600E–mutant metastatic colorectal cancer (mCRC), as detected by...

skin cancer

Prognostic Model for Treatment Outcomes in BRAF V600–Mutated Metastatic Melanoma

In a study reported in JAMA Oncology, Hauschild et al identified baseline lactate dehydrogenase (LDH), performance status, disease burden, and gene signature as potential determinants of treatment outcomes in BRAF V600–mutant metastatic melanoma treated with BRAF and/or MEK inhibitors. Study ...

Cory Wiegert Named New CEO of CancerLinQ LLC

Cory Wiegert has been named Chief Executive Officer (CEO) of CancerLinQ LLC, a wholly owned nonprofit subsidiary of ASCO. Mr. Wiegert, a proven expert in building and successfully launching innovative technology solutions, began his new role today (August 13, 2018), overseeing the continued...

breast cancer

ESR1 Fusions and Metastasis in Estrogen Receptor–Positive Breast Cancer

Estrogen receptor–positive breast cancer is the most common type of breast cancer, but resistance to therapy is common, and eventual development of metastatic disease is a leading cause of death. In research published by Lei et al in Cell Reports, researchers from Baylor College of...

issues in oncology

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how ...

Leading International Cancer Organizations Call on United Nations Members to Reduce Disease Burden

ASCO AND the European Society for Medical Oncology (ESMO) are calling on leaders and health ministers of the 193 United Nations (UN) member countries to reduce the burden of all noncommunicable diseases (NCDs), including cancer. The two organizations issued a joint statement in advance of the third ...

AMA House of Delegates Adopt ASCO Resolutions

ASCO DELEGATES participated in the American Medical Association’s (AMA) June Annual Meeting of the House of Delegates (HOD). The AMA HOD is the principal policy-making body of AMA and meets twice a year to discuss pressing issues and establish association policies.  This year, delegates approved...

ASCO Annual Meeting Merit Awards: This Year’s Winners

The Conquer Cancer Merit Awards support oncology trainees who are first authors on abstracts selected for presentation at an ASCO scientific meeting, including the ASCO Annual Meeting and thematic symposia. Conquer Cancer recognized 127 recipients with Merit Awards at the 2018 ASCO Annual Meeting,...

health-care policy

CMS Proposes Extended 340B Cuts for 2019

ON JULY 25, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Hospital Outpatient Prospective Payment System proposed rule. Among other provisions, the proposal would extend 2018 reimbursement cuts to the 340B Drug Pricing Program to include currently excepted, off-site...

breast cancer

TAILORx: How to Apply This Landmark Study

TAILORx changes the configuration of the ball field and the shape of the ball in deciding which women will be recommended chemotherapy after resection of node-negative, hormone receptor–positive breast cancer. TAILORx was presented by Joseph Sparano, MD, at the 2018 ASCO Plenary Session and...

gynecologic cancers

FDA Approves HPV Test for First-Line Cervical Cancer Screening

ON JULY 30, 2018, Roche announced approval by the U.S. Food and Drug Administration (FDA) of its cobas HPV Test in first-line screening for cervical cancer in women 25 years and older using cervical specimens collected in SurePath preservative fluid. The FDA first approved the cobas HPV test...

palliative care
immunotherapy

Meeting the Challenges of Immunotherapy-Related Toxicities

In 2011, the U.S. Food and Drug Administration (FDA) approved ipilimumab (Yervoy), an anticytotoxic T-lymphocyte– associated antigen 4 (CTLA-4), the first checkpoint inhibitor for the treatment of advanced melanoma.1 Since then, several more checkpoint inhibitors directed at both the programmed...

lung cancer

My Incidentally Discovered Cancer

In February 2015, there was no indication that my life was about to radically change. I was a practicing attorney and happily raising two young children with my husband. At 40 years old, I was healthy—or so I thought—and had no physical symptoms to alert me to the devastating news that was about to ...

symptom management

Actively Recruiting Clinical Trials Focused on Neurotoxicities of Treatment

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on neurotoxicities of cancer treatment. These studies focus on the effects of chemotherapy on cognitive function, changes in resting state brain networks after stem cell...

skin cancer

Encorafenib Plus Binimetinib in Unresectable or Metastatic Melanoma With BRAF Mutations

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. This past June, encorafenib (Braftovi) and binimetinib...

issues in oncology

Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records

Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities...

breast cancer

Risk of Breast Cancer After Negative Screening Mammography

A study reported in JAMA Oncology by Anne Marie McCarthy, PhD, of the Division of General Internal Medicine, Massachusetts General Hospital, and colleagues identified the risk of interval breast cancer after negative screening mammography, including the risk of poor-prognosis breast cancer. The...

health-care policy
issues in oncology

ASCO Statement: Step Therapy Creates Barriers to Care for Medicare Advantage Beneficiaries With Cancer

Monica M. Bertagnolli, MD, FACS, FASCO, ASCO President, released the following statement today: “ASCO strongly opposes the Centers for Medicare & Medicaid Services (CMS) decision to allow Medicare Advantage plans to employ step therapy across physician-administered and self-administered...

genomics/genetics

Is Some DNA Worthless?

BOOKMARK Title: Junk DNA: A Journey Through the Dark Matter of the GenomeAuthor: Nessa CareyPublisher: Columbia University PressOriginal publication date: April 2015Price: $22.95, paperback, 360 pages When biologists first delved into the human wonder of genes in the 1970s, they eventually...

A Celebrity Gadfly’s Reflections on His Death and Other Things Meant to Irritate

BOOKMARK Title: MortalityAuthor: Christopher HitchensPublisher: Twelve: Hachette Book GroupOriginal Publication Date: May 13, 2014Price: $19.95, paperback, 128 pages “There are no atheists in foxholes” is an aphorism used to contend that in times of extreme fear, such as during war or facing a...

issues in oncology

The Story of a Notorious Cluster of Childhood Cancers

BOOKMARK Title: Toms River: A Story of Science and SalvationAuthor: Dan FaginPublisher: Random HouseOriginal publication date: March 2013Price: $28.00, hardcover, 560 pages The Toms River emerges in the Pine Barrens of northern Ocean County, New Jersey, and zigzags through wetlands, emptying into...

prostate cancer

NIH and Prostate Cancer Foundation Launch Large Study on Aggressive Prostate Cancer in African American Men

The largest coordinated research effort to study biologic and nonbiologic factors associated with aggressive prostate cancer in African American men has begun. The $26.5 million study is called RESPOND, or Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor ...

solid tumors

FDA Approves First Treatment for Rare Adrenal Tumors

On July 30, 2018, the U.S. Food and Drug Administration (FDA) approved iobenguane I 131 injection (Azedra) for intravenous use in the treatment of adults and adolescents aged 12 and older with unresectable pheochromocytoma or paraganglioma that have spread beyond the original tumor site and require ...

health-care policy

Is Universal Health Care a Human Right?

The Affordable Care Act (ACA) provided oncology services to people with cancer who had previously been denied coverage. And for that reason alone, many oncologists supported its passage. However, even though the U.S. health-care system remains in the crosshairs of partisan politics, parties on both ...

issues in oncology

ASCO and Friends Submit Recommendations to FDA Aimed at Reducing Barriers to Clinical Trial Participation

ASCO and Friends of Cancer Research (Friends) have submitted recommended language to the U.S. Food and Drug Administration (FDA) for five guidance documents on ways to broaden eligibility criteria for cancer clinical trials. The recommendations are part of an ASCO...

breast cancer

Utilization of Hypofractionated Radiation Therapy in Breast Cancer

Researchers at the Feinstein Institute for Medical Research and Northwell Health’s Department of Radiation Medicine have identified methods to increase use of the radiation therapy hypofractionation in patients with breast cancer. These findings, published by Gilbo et al...

lung cancer
issues in oncology

Lung Cancer Screening Guidelines May Be Inadequate for High-Risk Minorities

Data from a lung cancer screening program at the University of Illinois at Chicago (UIC) provides evidence that national lung cancer screening guidelines, which were developed based on the National Lung Screening Trial (NLST) in 2011 and recommend screening based on age and smoking history, may be...

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