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A Lifetime Dedicated to Patients With Lung Cancer

Former ASCO President Paul Bunn, Jr, MD, FASCO, was born at the New York Hospital, the second oldest hospital in New York City and the third oldest in the nation. He grew up in DeWitt, New York, an eastern suburb of Syracuse, and went through the public-school system graduating from...

breast cancer

Fulvestrant/Anastrozole in Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Rita S. Mehta, MD, and colleagues, the final overall survival results of the phase III SWOG S0226 trial show that the addition of first-line fulvestrant to anastrozole was associated with improved overall survival in postmenopausal women with...

breast cancer

ACP Issues Guidance for Breast Screening in Average-Risk Women

AVERAGE-RISK women between the ages of 50 and 74 who have no symptoms of breast cancer should undergo breast cancer screening with mammography every other year, the American College of Physicians (ACP) has recommended in a new evidence-based guidance statement published by Qaseem et al in Annals of ...

integrative oncology

Capsaicin

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. In this installment, Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore the use of...

global cancer care

Uniting the Global Cancer Community to Reduce Deaths From Noncommunicable Diseases

It has been well documented that noncommunicable diseases, including cancer, cardiovascular disease, and diabetes, now pose the greatest health threat to people living in low- and middle-income countries, surpassing infectious diseases like HIV/AIDS as the leading cause of death and disability.1...

issues in oncology
cost of care
survivorship

How Cancer Affects Adolescents and Young Adults

The statistics are alarming: according to the National Cancer Institute (NCI), about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer each year1—a recent report by the University of California put that figure at 87,000.2 Although overall cancer survival rates continue to improve ...

hematologic malignancies
lymphoma

Combination Immunotherapy With Lenalidomide Plus Rituximab in Indolent NHL: Time to Replace Rituximab Monotherapy?

With increasing knowledge on the key role of the tumor microenvironment in lymphomagenesis, treatments for indolent B-cell lymphoma, especially follicular lymphoma, are mechanistically moving toward a more immunomodulatory approach. Chemotherapy-free regimens are an attractive alternative to...

hematologic malignancies

Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...

colorectal cancer

ASCO Guideline Recommends Shorter-Course Adjuvant Chemotherapy for Some Patients With Stage III Colon Cancer

In a clinical practice guideline released April 15, an ASCO Expert Panel outlined the latest recommendations for the duration of adjuvant chemotherapy with a fluoropyrimidine and oxaliplatin for patients with completely resected stage III colon cancer.1 New recommendations were based on the results ...

breast cancer

Trastuzumab Emtansine in Treatment of Residual Breast Cancer After Neoadjuvant Therapy: Who Will Benefit?

The discovery of trastuzumab has been revolutionary in the treatment of HER2-positive breast cancer, both in the metastatic and early-stage settings.1-6 This cannot be disputed. In the early-stage setting, the addition of trastuzumab to standard chemotherapy has led to a 50% gain in...

breast cancer

Adjuvant Trastuzumab Emtansine vs Standard Trastuzumab in Residual HER2-Positive Breast Cancer After Neoadjuvant Therapy

In the phase III KATHERINE trial reported in The New England Journal of Medicine,1Gunter von Minckwitz, MD, of the German Breast Group, Neu-Isenburg, and colleagues found that adjuvant treatment with the antibody-drug conjugate trastuzumab emtansine (T-DM1) improved invasive disease–free survival...

kidney cancer

Expert Point of View: Daniel George, MD

The CARMENA trial presented at the 2018 ASCO Annual Meeting, published simultaneously in The New England Journal of Medicine,1,2 and reported in this supplement to The ASCO Post, evaluated the role of nephrectomy in patients with metastatic renal cell carcinoma. Formal discussant of the trial,...

pancreatic cancer
genomics/genetics

ASCO Clinical Opinion Recommends Germline Testing for All Patients With Pancreatic Cancer

The recently released ASCO Clinical Practice Provisional Clinical Opinion on Evaluating Susceptibility to Pancreatic Cancer highlights the importance of emerging data indicating a relatively high rate of germline mutations in pancreatic cancer.1 Recent studies have demonstrated that up to 1 in 10...

kidney cancer
immunotherapy

Front-Line Therapy in Advanced Renal Cell Carcinoma: Developing a New Standard

THE FRONT-LINE systemic treatment landscape for metastatic renal cell carcinoma has undergone tremendous movement over the past several years. A better understanding of the current management paradigm for therapy-naive patients warrants a reflection of historic landmark clinical trials that have...

kidney cancer
immunotherapy

First-Line Therapy for Advanced Kidney Cancer: Combination Treatment vs Sunitinib

  TWO RECENTLY reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues,...

bladder cancer
kidney cancer
prostate cancer

A Year in Review

The past year has seen groundbreaking advances in the treatment of genitourinary (GU) cancers, which in some cases are resulting in altering the standard of care for patients with renal cell carcinoma, prostate cancer, and urothelial carcinoma. Some of the biggest changes that have occurred are for ...

hematologic malignancies

Evidence Builds for Treating Smoldering Myeloma

In patients with intermediate- to high-risk smoldering multiple myeloma, treatment with single-agent lenalidomide, vs observation, led to a 72% reduction in the risk of disease progression at 3 years.1 Results of the phase III E3A06 study were presented at a press briefing in advance of the 2019...

kidney cancer
immunotherapy

Front-Line Therapy in Advanced Renal Cell Carcinoma: Developing a New Standard

THE FRONT-LINE systemic treatment landscape for metastatic renal cell carcinoma has undergone tremendous movement over the past several years. A better understanding of the current management paradigm for therapy-naive patients warrants a reflection of historic landmark clinical trials that have...

issues in oncology

Harnessing the Power of Twitter for Clinical Trial Enrollment and Success

CLINICAL TRIALS are vital for advancing cancer care for our patients. Each trial represents an unanswered problem for which researchers are committed to solving. Designing, funding, recruiting, and completing a trial are tremendous undertakings for each researcher, physician, patient, and...

immunotherapy
skin cancer

Neoadjuvant Immunotherapy Associated With Improved Outcomes in Patients With Locally Advanced Melanoma

ACCORDING TO DATA from a small prospective study presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium,1 neoadjuvant immunotherapy significantly prolonged relapse-free survival vs adjuvant immunotherapy in patients with stage III or oligometastatic stage IV melanoma intended...

issues in oncology

Physician Identity and Physician Wellness Are Inextricably Linked

Imagine a 70-year-old patient who is scheduled for a pancreaticoduodenectomy. On the morning of surgery, the patient is checked in at the front desk by the “data-entry provider.” The patient is taken to the preoperative area, where the appropriate formalities are completed by multiple “bedside-care ...

issues in oncology

How Hepatitis C Virus Screening May Improve Survival in Patients With Cancer

In 2013, the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommended that all people born between 1945 and 1965 undergo one-time screening for the hepatitis C virus (HCV), because the rates of HCV infection are markedly higher for baby...

kidney cancer

First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment in advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...

hepatobiliary cancer

Ramucirumab After Sorafenib in Advanced Hepatocellular Carcinoma: An Efficacious Therapy With Applicability Challenges

In the 2 years since the U.S. Food and Drug Administration’s (FDA) approval of regorafenib in the treatment of patients with sorafenib-refractory advanced hepatocellular carcinoma, we oncologists have witnessed a veritable avalanche of newly approved medicines for the treatment of advanced...

gynecologic cancers

Effect of Lymphadenectomy on Progression-Free and Overall Survival in Advanced Ovarian Cancer

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

myelodysplastic syndromes

Early Studies of Two Regimens Show Benefit in High-Risk Smoldering Multiple Myeloma

MORE DATA are in to support early intervention for high-risk smoldering multiple myeloma—an early, asymptomatic entity lacking the presence of CRAB criteria (elevated calcium, renal failure, anemia, bone lesions). The latest come from two phase II studies presented at the 2018 American Society of...

multiple myeloma

Robert A. Kyle, MD, Luminary in Myeloma Research: Journey From a One-Room Schoolhouse to Groundbreaking Research

In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, interviewed multiple myeloma pioneer Robert A. Kyle, MD, whose groundbreaking work has changed the practice of hematology. Among his many honors are the David A. Karnofsky Memorial Award from ASCO and the Wallace H....

issues in oncology
lung cancer

Shared Decision-Making in Lung Cancer Screening: Whence? Whither?

We read with interest a recent article published on ASCOPost.com, which summarized a paper on the role of shared decision-making in lung cancer screening.1,2 The summary and original report highlight a mandate by the Centers for Medicare & Medicaid Services (CMS) that bears careful...

supportive care
integrative oncology

Maitake Mushroom

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York.         The ASCO Post’s Integrative Oncology series is intended to...

issues in oncology

Full Disclosure: What Oncologists Must Tell Patients About Their Experience and Training

Informed consent is an important part of delivering quality cancer care. Traditional ethical and legal rules require clinicians to disclose three types of information: (1) the patient’s diagnosis; (2) the nature of the proposed intervention and its intended benefits, risks, and adverse effects;...

hepatobiliary cancer

CELESTIAL Trial in Advanced Hepatocellular Carcinoma: Analysis on Quality-Adjusted Life-Years

ON JANUARY 14, 2019, the U.S. Food and Drug Administration (FDA) approved cabozantinib, an orally available receptor tyrosine kinase inhibitor, for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval was based on the results of the phase III...

prostate cancer

ARAMIS Trial: Darolutamide in High-Risk Nonmetastatic Prostate Cancer

THE INVESTIGATIONAL androgen receptor inhibitor darolutamide 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...

kidney cancer
immunotherapy

JAVELIN Renal 101: Avelumab Plus Axitinib vs Sunitinib in the First-Line Treatment of Advanced Kidney Cancer

THE PROGRAMMED cell death-ligand 1 (PD-L1) inhibitor, avelumab, was combined with the multitargeted vascular growth endothelial factor (VEGF) agent, axitinib, and compared to monotherapy with sunitinib in the first-line treatment of patients with metastatic renal cell carcinoma. Toni K. Choueiri,...

kidney cancer
immunotherapy

Expert Point of View: Lori Wood, MD

LORI WOOD, MD, of Dalhousie University in Halifax, Nova Scotia, Canada was the formal discussant for the KEYNOTE 426 study presented at the 2019 Genitourinary Cancers Symposium.1,2 Dr. Wood called the KEYNOTE 426 phase III trial “practice-changing,” and added, “The majority of patients with...

kidney cancer
immunotherapy

KEYNOTE 426: Pembrolizumab Plus Axitinib vs Sunitinib in First-Line Therapy for Advanced Renal Cell Carcinoma

AS REPORTED at the 2019 Genitourinary Cancers Symposium by Thomas Powles, MD, and as published in The New England Journal of Medicine by Brian Rini, MD, and colleagues, significant benefits in overall and progression-free survival were achieved with the combination of pembrolizumab plus axitinib...

kidney cancer
bladder cancer
prostate cancer
hepatobiliary cancer

Conference Highlights From the 2019 Gastrointestinal and Genitourinary Cancers Symposiums

THIS YEAR saw a huge turnout and a large number of scientific abstracts presented at both the 2019 Gastrointestinal (GI) Cancers Symposium, held on January 17–19, and the 2019 Genitourinary (GU) Cancers Symposium, held on February 14–16, both in San Francisco. The GU Cancers Symposium attracted...

prostate cancer

ASCO Endorses Active Surveillance Guideline for Low-Risk Prostate Cancer

ASCO ENDORSES and reinforces the evidence-based American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) Guideline published in 2018 in the Journal of Urology. ASCO’s endorsement of a guideline on clinically localized...

prostate cancer

Prostatectomy vs Watchful Waiting: Clinical Dilemma Centers on Aggressive vs Indolent Disease

THE MANAGEMENT of localized prostate cancer remains controversial. Although the widespread use of prostate-specific antigen (PSA) testing has resulted in a dramatic increase in the diagnosis and treatment of prostate cancer, many men do not benefit from intervention because the disease is either...

prostate cancer

Radical Prostatectomy or Watchful Waiting: 29-Year Follow-up of Scandinavian Trial

AS REPORTED in The New England Journal of Medicine by Anna Bill-Axelson, MD, PhD, Lars Holmberg, MD, PhD, both of Uppsala University Hospital, and and colleagues, the 29-year follow-up of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial has shown that radical prostatectomy is...

multiple myeloma
immunotherapy

Expert Point of View: Ajay K. Nooka, MD, MPH

THE ASCO POST asked Ajay K. Nooka, MD, MPH, Associate Professor, Division of Bone Marrow Transplant at Winship Cancer Institute, Emory University, to comment on studies involving daratumumab. “After the phase III SWOG S0777 trial demonstrated a survival benefit with a 3-drug induction regimen...

breast cancer
immunotherapy

IMpassion130 Substudy: Atezolizumab/Nab-Paclitaxel Survival Benefits Limited to PD-L1–Positive Triple-Negative Breast Cancer

THE PHASE III IMpassion130 trial, first reported at the European Society for Medical Oncology (ESMO) 2018 Congress1 and published in The New England Journal of Medicine,2 found that the combination of front-line atezolizumab plus nab-paclitaxel significantly improved disease-free and overall...

issues in oncology

The Risks of Drug Approval Based on Shaky Evidence

Two recent publications in The New England Journal of Medicine (NEJM), and the resulting drug approval applications that have already been filed, lead to concern that the basis of medical practice on valid evidence may be corrupted. Each involves statistically shaky analysis leading to a striking...

ASCO President-Elect Howard A. Burris III, MD, FACP, FASCO, Gained Leadership Skills From His Experience at West Point

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. In this installment of Living a Full Life, guest editor Jame Abraham, MD, spoke with Howard A. “Skip” Burris III, MD, FACP,...

hematologic malignancies
lymphoma

CAR T-Cell Therapy for DLBCL: At the Crossroads of Hype and Reality

In the 20-plus years I have spent in hematologic oncology, I have been fortunate to have a ringside seat to watch “game-changing” advances come into our field—all-trans retinoic acid for acute promyelocytic leukemia, tyrosine kinase inhibitors starting with imatinib for chronic myeloid leukemia,...

hematologic malignancies
lymphoma

Tisagenlecleucel Active in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma

As reported in The New England Journal of Medicine by Stephen J. Schuster, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, the international phase II JULIET trial has shown high response rates with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel in...

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...

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...

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