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The X-Ray Era 1901–1915

The text and photograph on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photo below is from the volume titled “The X-Ray Era: 1901–1915.” The photograph appears...

prostate cancer

Adverse Pathologic Findings in Low-Volume Intermediate-Risk Prostate Cancer

In a single-center analysis reported in JAMA Oncology, Patel et al found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk disease had significantly higher rates of adverse pathologic findings compared than did those with very low-risk and low-risk...

gynecologic cancers

Olaparib Tablets as Maintenance in BRCA1/2-Mutant Platinum-Sensitive Relapsed Ovarian Cancer

A phase III trial (SOLO2/ENGOT-Ov21) has shown improved progression-free survival with an olaparib tablet formulation vs placebo as maintenance therapy in patients with BRCA1/2-mutant platinum-sensitive relapsed ovarian cancer. These study results were reported by Pujade-Lauraine et al in The...

Searching for Happiness

This is the story, told through their own photographs, of a group of adolescent patients with cancer in their search for happiness. Their images relay their hopes and fears, their desire to be normal, and their urge to escape. These photographs are the outcome of a creative arts–based support...

issues in oncology
survivorship

How to Help Young Patients Preserve Their Fertility

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Professor of Medicine and Medical Director...

breast cancer

One Size May Not Fit All: Thoughts on the New Adjuvant Bisphosphonate Guideline for Early-Stage Breast Cancer

The oncology community has now conducted several prospectively designed, hypothesis-driven randomized clinical trials among women with breast cancer to address this question: Do adjuvant bisphosphonates decrease the risk of breast cancer bone metastases and other recurrence? A meta-analysis1 by...

breast cancer

Advances in the Treatment of Triple-Negative Breast Cancer

WITHIN THE SPECTRUM of breast cancer subtypes, triple-negative disease is “particularly troubling,” but better scientific understanding of this malignancy is leading to advances in its treatment, according to breast cancer expert Nancy Davidson, MD.  Triple-negative breast cancer does not express...

cost of care

Financial Toxicity: Cancer Supportive Care Professionals Consider the Side Effects of Soaring Costs

IS IT POSSIBLE to identify patients with cancer who are at risk for financial stress and intervene to reduce that risk? And could reducing financial stress—or financial toxicity, as it is often called in the context of cancer care—improve both health-related quality of life and physical health?...

hematologic malignancies
multiple myeloma
lymphoma
leukemia
myelodysplastic syndromes

Selected Abstracts on Novel Therapies for Hematologic Malignancies

THE 22ND CONGRESS of the European Hematology Association (EHA) was held in June in Madrid, drawing hematologists and allied professionals from every subspecialty of hematology from around the world. Among the extensive educational and scientific program, the EHA Congress provides a forum for...

genomics/genetics

Convergence of Precision Medicine and Immuno-oncology

“THE CONVERGENCE of two very hot and interesting topics—precision medicine and immuno-oncology”—is being advanced by next-generation sequencing, Douglas B. Johnson, MD, MSCI, made clear at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine,” sponsored by the Robert H. Lurie ...

colorectal cancer

New Data Reported on Vemurafenib, Vitamin D, Selective Internal Radiotherapy, and Circulating Tumor DNA in Colorectal Cancer

RESULTS OF the IDEA trial, which showed that some patients with stage III low-risk colon cancer may require less oxaliplatin therapy (see the June 25 issue of The ASCO Post), were among the findings highlighted at the 2017 ASCO Annual Meeting Plenary Session. Other studies of interest in colorectal ...

breast cancer
leukemia
supportive care
gastrointestinal cancer

FDA Actions Yield Extended Approvals of Novel Agents, Advisory Committee Votes Favorably on Two Biosimilars and Pediatric Indication for CAR T-Cell Therapy

DURING JULY, the U.S. Food and Drug Administration (FDA) and its Oncologic Drugs Advisory Committee (ODAC) made a number of approvals and recommendations on a variety of oncology products.  Neratinib  ON JULY 1 7, the FDA approved neratinib (Nerlynx) for the extended adjuvant treatment of adult...

supportive care
symptom management

FDA Expands Ibrutinib Indications to Chronic Graft-vs-Host Disease

On August 2, 2017, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica) for the treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy. This is the first FDA-approved therapy for the treatment of chronic...

sarcoma
cns cancers
lymphoma
survivorship

In Case You Missed It: Short Takes on Current Cancer Research

MOST ONCOLOGISTS are familiar with the findings of the plenary sessions featured at the 2017 ASCO Annual Meeting, with topics ranging from the duration of adjuvant oxaliplatin-based therapy in stage III colon cancer to patient-reported outcomes for symptom monitoring during routine cancer...

issues in oncology
solid tumors

FDA’s First Site-Agnostic Drug Approval Marks a Paradigm Shift in Regulatory Criteria

IN MAY, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with solid tumors that have the microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) biomarker, which disrupts the ability of cells to repair DNA. The...

issues in oncology

Tissue Specimens in Clinical Trials: A Double-Edged Sword

AN INCREASING number of clinical trials require the submission of tissue specimens, either from archived specimens or increasingly from fresh biopsies taken after enrollment into the trial. These specimens can be either mandatory, required to determine whether a given patient has the required...

breast cancer

A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer

THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al in the...

palliative care

An Educational Program for Safe Handling of Opioids

Improper storage, use, and disposal of prescribed opioids can lead to diversion or accidental overdose. Given that opioids are the mainstay of cancer pain treatment, this issue is particularly germane in the oncology community. The ASCO Post recently spoke with Akhila Reddy, MD, and Maxine de la...

issues in oncology
health-care policy

First Oncologist Elected AMA President, Barbara L. McAneny, MD, Advocates for Access to Health Care for Everyone

Since the founding of the American Medical Association (AMA) in 1847, Barbara L. McAneny, MD, is the fourth woman and first oncologist to be elected President of the venerable medical association. “I’m a generic Midwesterner. I was born in Missouri and raised in Madison County, Illinois, and went...

cns cancers

Effect of BRAF V600E Mutation on Outcome in Pediatric Low-Grade Gliomas

An analysis reported by Lassaletta et al in the Journal of Clinical Oncology showed that BRAF V600E mutation is associated with a poor outcome in pediatric low-grade gliomas treated with standard adjuvant therapy. Study Details The study involved patients with low-grade gliomas with long-term...

prostate cancer

Comparison of Circulating Tumor DNA and Metastatic Tissue Biopsy in Identifying Mutations in Prostate Cancer

In a study reported in the Journal of the National Cancer Institute, Wyatt et al found high agreement between driver mutations in plasma circulating tumor DNA (ctDNA) and metastatic tissue biopsy in castration-resistant prostate cancer. Mutations Identified in ctDNA In the study, targeted...

leukemia

FDA Approves Enasidenib in Relapsed or Refractory Acute Myeloid Leukemia

Today, the U.S. Food and Drug Administration (FDA) approved enasidenib (Idhifa) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) who have a specific genetic mutation. The drug is approved for use with a companion diagnostic, the RealTime IDH2 Assay, which ...

colorectal cancer

FDA Approves Nivolumab in MSI-H or dMMR Metastatic Colorectal Cancer

Today, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) injection for intravenous use for the treatment of adult and pediatric (12 years and older) patients with microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer...

leukemia

Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia

An observational study reported in The Lancet Oncology by Wolthers et al in the Ponte di Legno Toxicity Working Group identified characteristics and the course of asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia. Study Details The study involved merged data from...

lung cancer

Tremelimumab in Previously Treated Advanced Malignant Mesothelioma

In the randomized phase IIB DETERMINE trial, the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab did not improve overall survival vs placebo as second- or third-line treatment of relapsed malignant mesothelioma. These findings were reported in The Lancet Oncology...

breast cancer

Fulvestrant Receives EC Approval as First-Line Therapy for Advanced Breast Cancer

On July 26, the European Commission (EC) approved fulvestrant (Falsodex) for the treatment of estrogen receptor–positive, locally advanced or metastatic breast cancer in postmenopausal women not previously treated with endocrine therapy. The EC approval is based on pivotal data from the...

skin cancer

Standard-Dose Pembrolizumab Plus Reduced-Dose Ipilimumab in Advanced Melanoma

In the phase IB KEYNOTE-029 study, standard-dose pembrolizumab (Keytruda) plus reduced-dose ipilimumab (Yervoy) produced high response rates in patients with advanced melanoma. These results were reported by Long et al in The Lancet Oncology. Study Details In the study, 153 patients with...

lung cancer

Study Finds HER2 Mutations in 3% of Lung Cancers

The Lung Cancer Mutation Consortium at the University of Colorado Cancer Center reported that 24 of 920 patients (3%) with advanced-stage lung cancer in a recent study had mutations in the gene HER2. According to the study, published by Pillai et al in Cancer, 71% of these patients were...

breast cancer

Genetic Study Identifies Susceptibility Loci Modifying Risk for Breast Cancer After Radiation Therapy for Childhood Cancer

As reported in the Journal of the National Cancer Institute, Morton et al have identified gene loci associated with radiation-related risk of breast cancer in survivors of childhood cancer. Study Details The study was a genome-wide association study of breast cancer in female survivors of...

leukemia

Response to CAR T-Cell Therapy After Ibrutinib in Chronic Lymphocytic Leukemia

As reported by Turtle et al in the Journal of Clinical Oncology, anti-CD19 chimeric antigen receptor–modified (CAR) T-cell therapy produced high response rates in patients with chronic lymphocytic leukemia previously treated with ibrutinib (Imbruvica). Study Details In the phase I/II study, ...

gastrointestinal cancer

Classifying Gastric Cancers by Subtype May Provide Tailored Treatment Options

Gastric cancer is the third leading cause of cancer death in both men and women worldwide. In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability (MSI), genomically stable (GS), and...

prostate cancer

Surgery vs Observation in Localized Prostate Cancer: Long-Term Follow-up of PIVOT Trial

After 19.5 years of follow-up in the PIVOT trial, radical prostatectomy was not associated with significantly improved all-cause or prostate cancer mortality vs observation among men with localized prostate cancer. The long-term follow-up data were reported in The New England Journal of Medicine by ...

issues in oncology
survivorship

Poor Social Functioning in Adolescent and Young Adult Cancer Survivors

A new study indicates many young adults who survived the disease struggle with “getting back to normal” as much as 2 years after their initial diagnosis. The longitudinal study, published by Husson et al in Cancer, is among the first seeking to understand the social functioning among...

solid tumors

COX-2 Inhibitors May Reverse IDO1-Mediated Immunosuppression in Some Cancers

In preclinical studies, tumors that consitutively expressed the protein indoleamine 2,3-dioxygenase (IDO1) responded to the cyclooxygenase-2 (COX-2) inhibitor celecoxib (Celebrex) and had improved infiltration of certain subsets of T cells, making them more likely to respond to...

lung cancer

Concurrent Chemotherapy, Proton Therapy May Improve Survival in Patients With Advanced Lung Cancer

For patients with advanced, inoperable stage III lung cancer, concurrent chemotherapy and proton-beam radiotherapy offers improved survival compared to historical data for standard of care, according to a new study from The University of Texas MD Anderson Cancer Center. The research, published by...

issues in oncology

Social Interaction May Affect Patients’ Response to Chemotherapy

How well patients with cancer fared after chemotherapy was affected by their social interaction with other patients during treatment, according to a new study by researchers at the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health, and the University of...

The Art of Networking: Advice for the Oncologist-in-Training

It was Friday night of the 2016 ASCO Annual Meeting in Chicago. I planned to meet a friend, another 2nd-year heme-onc fellow, at a “free drink thing,” as she called it. I sheepishly entered the hotel bar, made a nametag at the insistence of the greeter, and started edging my way through the crowd. ...

2017 ASTRO Gold Medalists Named

THE AMERICAN SOCIETY FOR RADIATION ONCOLOGY (ASTRO) has announced the 2017 ASTRO Gold Medalists. Søren M. Bentzen, DSc, PhD; Louis B. Harrison, MD, FASTRO; and Michael L. Steinberg, MD, FASTRO, have been awarded the annual honor given to ASTRO members who have made outstanding lifetime...

Khurshid Guru, MD, Named Chair of Urology at Roswell Park

KHURSHID GURU, MD, an acclaimed robotic surgeon, has been named Chair of the Department of Urology at Roswell Park Cancer Institute. Dr. Guru, who was recruited to Roswell Park in 2005 to direct the Institute’s robotic surgery program, will lead a team of more than 50 faculty members, clinicians,...

head and neck cancer

Pembrolizumab and Cetuximab-Treated Head and Neck Cancer: Activity Confirmed But No Surprises

WITH THE RECENT efficacy findings, improvements in survival, and resultant U.S. Food and Drug Administration (FDA) approvals of programmed cell death protein 1 (PD-1) immune checkpoint inhibitors across multiple solid tumor indications, the publication of yet another positive trial adds to the...

head and neck cancer

Pembrolizumab Is Active in Platinum- and Cetuximab-Refractory Head and Neck Cancer

IN THE PHASE II KEYNOTE-055 trial, pembrolizumab (Keytruda) was found to produce durable responses in patients with platinum- and cetuximab (Erbitux)-refractory head and neck squamous cell carcinoma.1 Results of the trial were reported by Joshua Bauml, MD, of the University of Pennsylvania,...

bladder cancer

Pembrolizumab in Second-Line Therapy for Advanced Urothelial Carcinoma

THE TREATMENT OF metastatic urothelial carcinoma experienced a long period of stagnation until the recognition that targeting the programmed cell death protein 1 (PD-1) pathway could yield deep and durable responses.1-3 Cisplatin-based combination chemotherapy has been the reference standard for...

health-care policy

Insurance Approval Rates for Enrollment in Oncology Clinical Trials Increased Under Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) of 2010 was the first federal law to mandate that group health insurance plans and state-licensed insurance issuers provide coverage of standard-of-care costs for patients enrolled in approved clinical trials, effective on January 1, 2014. Under...

cns cancers

Analysis Reveals Genomic Alterations, Oncogenes Driving Medulloblastoma Subtypes

The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75% of the brain tumors, including two new suspected cancer genes that were found exclusively in the least understood disease subgroups. The study from an international research...

multiple myeloma

Comparison of MRI vs PET-CT in Multiple Myeloma

A study reported by Moreau et al in the Journal of Clinical Oncology indicated no difference between magnetic resonance imaging (MRI) and positron-emission tomography–computed tomography (PET-CT) in detecting bone lesions at diagnosis in patients with multiple myeloma. PET-CT normalization...

cns cancers

Single-Center Trial of Stereotactic Radiosurgery for Completely Resected Brain Metastases

In a U.S. single-institution study reported in The Lancet Oncology, Mahajan et al found that stereotactic radiosurgery to the surgical cavity reduced local recurrence vs observation in patients with completely resected brain metastases. Study Details In the trial, 128 evaluable patients at MD...

gastroesophageal cancer

Addition of Cetuximab to Concurrent Chemoradiation in Esophageal Cancer

The phase III NRG Oncology RTOG 0436 trial has shown no survival benefit of adding cetuximab (Erbitux) to paclitaxel/cisplatin and radiation therapy in patients with esophageal cancer treated without surgery. These results were reported by Suntharalingam et al in JAMA Oncology. Study Details In...

bladder cancer

Pembrolizumab Improves Overall Survival vs Chemotherapy in Second-Line Therapy for Advanced Urothelial Carcinoma

IN THE PHASE III KEYNOTE-045 trial reported in The New England Journal of Medicine, Joaquim Bellmunt, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that pembrolizumab (Keytruda) significantly improved overall survival vs investigator choice of chemotherapy as second-line treatment ...

breast cancer
cns cancers

Breast Cancer and Brain Metastases: Whole-Brain Radiotherapy May Not Be the Answer

FOR PATIENTS WITH BREAST CANCER who have metastases to the central nervous system (CNS), clinicians should think twice before administering whole-brain radiotherapy, according to Kimberly Blackwell, MD, Professor of Medicine and Assistant Professor of Radiation Oncology at Duke University Medical...

lung cancer

Checkpoint Inhibitors May Prove to Be Effective in Mesothelioma

CHECKPOINT INHIBITION was effective against malignant pleural mesothelioma in the MAPS-2 study of the French Cooperative Thoracic Intergroup. At the 2017 ASCO Annual Meeting, researchers reported a disease control rate of up to 50% when patients were treated with immunotherapy after relapse in a...

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