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Key Leadership in Place in Trump Administration

IN JUNE 2017, President Trump installed the final member of his cancer care leadership team, Norman “Ned” Sharpless, MD, who will serve as the Director of the National Cancer Institute. Director Sharpless is an accomplished researcher with experience leading a wide range of clinical and...

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,...

Solange Peters, MD, PhD, Elected 2020–2021 ESMO President

THE EUROPEAN SOCIETY for Medical Oncology (ESMO) has announced that the President of the Society for the 2020–2021 term will be Solange Peters, MD, PhD, Head of the Medical Oncology Service and Chair of Thoracic Oncology, Oncology Department at the Centre Hospitalier Universitaire Vaudois in...

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...

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...

symptom management

Understanding and Managing Radiation-Induced Bystander Effect

More than half of patients with cancer undergo radiotherapy. Due to a phenomenon known as radiation-induced bystander effect, in which irradiated cells leak chemical signals that can travel some distance to damage unexposed healthy cells, many suffer side effects such as hair loss, fatigue, and...

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...

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...

gynecologic cancers

Expert Point of View: Ritu Salani, MD, MBA

STUDY DISCUSSANT Ritu Salani, MD, MBA, of The Ohio State University Wexner Medical Center, Columbus, agreed with the LION trial investigators.  “Omitting systemic lymph node dissection in patients who have both radiographic and clinically negative lymph nodes is acceptable,” she said. “I always...

gynecologic cancers

Study Supports Omission of Lymphadenectomy in Node-Negative Advanced Ovarian Cancer

SYSTEMATIC LYMPHADENECTOMY in patients with advanced ovarian cancer and complete resection offered no improvement in progression-free or overall survival in the Gynecologic Cancer Intergroup’s LION trial, reported at the 2017 ASCO Annual Meeting by Philipp Harter, MD, PhD, of the German...

solid tumors

Combination Strategies for Jump-Starting the Immune Response

CHECKPOINT INHIBITORS have dramatically changed the landscape of the treatment of melanoma, lung, bladder, and other cancers. Researchers are focusing on exploring ways to extend the use of checkpoint inhibitors to other disease states and to combine them with novel agents and improve outcomes.  At ...

colorectal cancer

Tumor ‘Sidedness’ in Colon Cancer: Studies Look for Explanations

TUMOR “SIDEDNESS” in colon cancer has become a topic of great interest, after right-sided tumors were shown to have a worse prognosis than left-sided ones and biologics were found to differ in efficacy based on side. At the 2017 ASCO Annual Meeting, studies explored why this might be so.  Three...

symptom management

Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient

SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1  Up to 10% of all patients with cancer will...

leukemia

Pivotal CAR T-Cell Data Reported in Relapsed/Refractory B-Cell ALL

UPDATED RESULTS from the ELIANA clinical trial of CTL019 (tisagenlecleucel)—an investigational chimeric antigen receptor (CAR) T-cell therapy—found that remission rates are maintained at 6 months in relapsed/refractory pediatric and young adult patients with B-cell acute lymphoblastic leukemia....

skin cancer
cns cancers

Drug Combinations Prove Effective Against Melanoma Brain Metastases

STUDIES PRESENTED at the 2017 ASCO Annual Meeting have shown that for melanoma that metastasizes to the brain, the combined use of checkpoint inhibitors and targeted agents can be effective.  In COMBI-MB, 58% of patients responded intracranially to the BRAF inhibitor dabrafenib (Tafinlar) plus the...

health-care policy

Maintaining Predictable Increases in NIH Funding for Cancer Research

CONGRESS RECENTLY passed its fiscal year (FY) 2017 spending bill, which contains an additional $2 billion for the National Institutes of Health (NIH). This marks the first time in more than a dozen years that Congress funded back-to-back increases for the NIH, demonstrating the bipartisan...

hepatobiliary cancer

FDA Approves Three-Drug Combination Tablet for Hepatitis C

On July 18, the U.S. Food and Drug Administration (FDA) approved a combination tablet (Vosevi) to treat adults with chronic hepatitis C virus genotypes 1–6 without cirrhosis or with mild cirrhosis. This fixed-dose, combination tablet contains two previously approved drugs—sofosbuvir and ...

issues in oncology

Understanding of Stage and Cancer Status Among Patients in a Community-Based Cancer Institute

As reported by Sivendran et al in the Journal of Oncology Practice, half of patients in a large community-based cancer institute did not know their stage of cancer, and one-third did not know of their cancer-free/in-remission status. Study Details The study involved 208 adult patients treated at...

skin cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

lung cancer

Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer

A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...

supportive care
integrative oncology

Music Therapy: Relevance in Oncology

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Karen Popkin, LCAT, MT-BC, and Jyothirmai Gubili, MS, present the case ...

A Frank Memoir About Doctors, Patients, and the Health-Care System

“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...

pancreatic cancer

Stereotactic Body Radiotherapy for Poor Performance Status Patients With Pancreatic Cancer

There are few data to guide the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have a poor performance status. Although most such patients are offered supportive care or gemcitabine alone, the addition of stereotactic body radiotherapy may improve...

multiple myeloma
survivorship

Living With Cancer Survivorship Guilt

Although I was officially diagnosed with multiple myeloma in 1997, the first sign of the cancer was evident 2 years earlier, when a single lesion (a plasmacytoma) was found in a bone in my lower back. The bone was replaced with two thin stainless steel rods, and after a course of radiation therapy, ...

A Social Media Guide by a Doctor for Doctors

Today’s brave new world of digital technology has both enhanced and compromised the day-to-day operational efficiency of ultrabusy oncologists who are struggling to balance patient care with the rapid evolution of technology. Like all scientific advances, health-care technology is a double-edged...

supportive care
palliative care

Ensuring Advance Directives Are Followed and Lawsuits Are Avoided

Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...

supportive care
palliative care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

breast cancer

Neoadjuvant Radiation Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Moffitt Cancer Center researchers conducted a first-of-its-kind study comparing the long-term benefits of radiation therapy in women with breast cancer in the neoadjuvant and adjuvant settings. Their study, published by Poleszczuk et al in Breast Cancer Research, found that patients who have...

issues in oncology

The Immune System: Deciphering Recent Advances

Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the...

issues in oncology

FDA Takes Action Against 14 Companies for Selling Illegal Cancer Treatments

On April 25, the U.S. Food and Drug Administration (FDA) posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat, or cure cancer. The products are marketed and sold without FDA approval, most commonly...

leukemia

Effect of Methotrexate and Corticosteroid Strategies on Neurocognitive Function in Patients With B-Lineage ALL

In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia regardless of...

breast cancer

MammaPrint Scoring and Indolent Node-Negative Breast Cancer

In an analysis reported in JAMA Oncology, Esserman et al found that an ultralow-risk designation using the 70-gene MammaPrint assay is capable of identifying patients with node-negative disease who have a very low long-term risk of death from breast cancer after surgery without systemic therapy....

skin cancer

Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma

In a retrospective analysis reported in JAMA Oncology, Long et al found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1–defined disease...

leukemia

CD33 Splicing Polymorphism and Response to Gemtuzumab Ozogamicin in AML

In an analysis of the phase III Children’s Oncology Group AAML0531 trial, published by Lambda et al in the Journal of Clinical Oncology, the CD33-targeted immunoconjugate gemtuzumab ozogamicin was shown to have benefit among patients with de novo acute myeloid leukemia (AML) who carry the CC...

issues in oncology

Cancer Risk May Be Higher Among Holocaust Survivors

A new study indicates that survivors of the Holocaust have experienced a small but consistent increase in the risk of developing cancer. Published by Sadetzki et al in Cancer, the findings offer an example of how extreme population-level tragedies can have an impact on health. Holocaust survivors...

leukemia

Blinatumomab Granted Full Approval to Treat Relapsed or Refractory B-cell Precursor ALL in Adults and Children

On July 11, the U.S. Food and Drug Administration (FDA) approved the supplemental Biologics License Application (sBLA) for blinatumomab (Blincyto) to include overall survival data from the phase III TOWER study. The approval converts blinatumomab's accelerated approval to a full approval. The sBLA...

lung cancer

FDA Approves First Companion Diagnostic Test to Simultaneously Screen for Multiple NSCLC Therapies

On June 22, the U.S. Food and Drug Administration (FDA) granted premarket approval to Thermo Fisher Scientific for the first next-generation sequencing–based test that simultaneously screens tumor samples for biomarkers associated with three FDA-approved therapies for non–small cell...

breast cancer

Priority Review Granted for Abemaciclib in the Treatment of Advanced Breast Cancer

On July 10, the U.S. Food and Drug Administration (FDA) accepted a new drug application (NDA) for abemaciclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor, and gave the NDA a Priority Review designation. The NDA includes Eli Lilly and Company’s submission of abemaciclib for two indications: ...

skin cancer

Overall Survival With Nivolumab vs Chemotherapy in Ipilimumab-Refractory Advanced Melanoma

As reported in the Journal of Clinical Oncology by Larkin et al, the phase III CheckMate 037 trial has shown no difference in overall survival with nivolumab (Opdivo) vs investigator’s choice of chemotherapy in ipilimumab (Yervoy)-refractory advanced melanoma. More chemotherapy patients never ...

breast cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The...

health-care policy
issues in oncology

Narrow Network Insurance Plans More Likely to Exclude Doctors at NCI-Designated and NCCN Member Cancer Centers

Patients with cancer in the United States may be unable to access care at the nation’s top hospitals due to narrow insurance plan coverage—leaving patients to choose between lower premiums or access to higher-quality cancer care. A new study from the Perelman School of Medicine at the...

skin cancer
issues in oncology

Delaying Lymph Node Biopsy After Melanoma Diagnosis May Not Adversely Affect Survival Rates

Postponing lymph node biopsy more than 30 days after melanoma diagnosis does not adversely impact long-term clinical outcomes, according to findings published by Nelson et al in the Journal of the American College of Surgeons. Today, management of high-risk melanomas starts with surgical removal...

multiple myeloma

FDA Places Clinical Hold on Three Studies Evaluating Pembrolizumab in Multiple Myeloma

On July 5, Merck announced that the U.S. Food and Drug Administration (FDA) has placed a clinical hold on KEYNOTE-183, KEYNOTE-185, and KEYNOTE-023, three combination studies of pembrolizumab (Keytruda), an anti–programmed cell death protein 1 (PD-1) therapy, in multiple myeloma. This...

cns cancers

FDA Approves Aminolevulinic Acid Hydrochloride as an Optical Imaging Agent Indicated in Gliomas

ON JUNE 6, the U.S. Food and Drug Administration (FDA) approved aminolevulinic acid hydrochloride, known as ALA HCl (Gleolan), as an optical imaging agent indicated in patients with gliomas (suspected World Health Organization [WHO] grades III or IV) for preoperative imaging, as an adjunct for the...

pancreatic cancer

Has a New Standard Really Been Established for the Adjuvant Treatment of Pancreatic Cancer?

THE PAST YEAR has undoubtedly been a disappointing one as far as clinical advances in pancreatic cancer go. No fewer than five high-profile randomized phase II or III trials in this setting reported negative results in 2016, ranging from next-generation cytotoxic agents1 to novel immunotherapeutic ...

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