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Doctoring in the Digital Age: Modern Stressors, Ancient Strategies to Cope

In my 45 years of practicing hematology/oncology at a major urban academic medical center, I have observed a sea change in daily practice that contributes to physician burnout. Although the emotional stresses of caring for seriously ill people play a part in physician burnout, I find the daily...

lymphoma
immunotherapy
symptom management

Early Steroid Use May Reduce Toxicity With CAR T-Cell Therapy

In patients with large B-cell lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy with axicabtagene ciloleucel, earlier-than-usual intervention with corticosteroids and tocilizumab may reduce the incidence of severe cytokine-release syndrome, according to the findings of a...

A Retired Oncologist Remains Involved in the Science and Policy of Oncology

The history of medicine once was featured in medical school curricula. That is becoming less common due to time restriction and the increased prevalence of more technical topics. However, the importance of the history of medicine cannot be overstated: It shapes every aspect of our cultural,...

issues in oncology

Comparing Prescribing Habits in Academic and Nonacademic Oncology Settings

The art of oncology practice is tailored to the individual patient with cancer, and with the advent of highly personalized targeted therapies, patient outcomes have improved markedly over the past several decades. Although much of oncology practice is guideline- or protocol-driven, chemotherapy...

colorectal cancer

Incidence Increases in New Colorectal Cancer Diagnoses Among Patients Between 49 and 50 Years Old

A year-by-year age analysis of colorectal cancer rates among adults in the United States has found a 46% increase in new diagnoses from ages 49 to 50, indicating that many latent cases of the disease are likely going undiagnosed until routine screenings begin at 50, according to a new study by...

breast cancer
issues in oncology

Is Distance to Treatment a Burden for Rural Patients With Breast Cancer?

A study published by Longacre et al in The Journal of Rural Health found that patients with breast cancer in the rural United States typically travel three times farther than those who live in urban areas for radiation therapy. Researchers examined data from the Surveillance, Epidemiology, and End ...

skin cancer

Circulating Tumor Cell Assessment to Predict Melanoma Relapse

A study published by Anthony Lucci, MD, and colleagues in Clinical Cancer Research showed that the presence of circulating tumor cells was independently associated with relapse of melanoma, suggesting circulating tumor cell assessment may be a useful tool for identifying patients at risk for...

lung cancer

Effect of Volume-Based CT Screening on Lung Cancer Mortality in High-Risk Patients

As reported in The New England Journal of Medicine by Harry J. de Koning, MD, PhD, and colleagues, the Dutch/Belgian NELSON trial has shown a significant reduction in 10-year lung cancer mortality with volume-based low-dose computed tomography (CT) screening vs no screening in high-risk men. Male...

Clinical Cancer Advances 2020: ASCO Names Advance of the Year, Issues Research Priorities for the Cancer Community

In the release of its annual report on progress against cancer, Clinical Cancer Advances 2020, ASCO recognized progress in the refinement of the surgical treatment of cancer as the Advance of the Year. In particular, the emergence of novel systemic therapies—combined in new and better ways—has...

lung cancer

ASCO Guideline Addresses Surveillance of Lung Cancer After Curative-Intent Therapy

ASCO has released a new guideline providing recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive, curative-intent therapy in patients with stage I to III non–small cell lung cancer or small cell lung cancer. These guideline...

gynecologic cancers

Diffusion-Weighted MRI May Help Predict Treatment Response in Patients With Advanced Ovarian Cancer

A simple test using a magnetic resonance imaging (MRI) scan may be used to predict how well people with advanced epithelial ovarian cancer will respond to treatment, according to the results of a new study published by Winfield et al in Radiology. In a large clinical trial, scientists have shown a...

global cancer care

WHO, IARC Release Reports in Response to Government’s Role in Cancer Control

The World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) released two coordinated reports in light of World Cancer Day in response to government calls for more research into the scope and potential policies and programs to improve cancer control. WHO Report...

global cancer care

World Cancer Day 2020: 20th Anniversary of the Global Initiative

Today’s World Cancer Day, led by the Union for International Cancer Control (UICC), aims to mobilize urgent action from individuals, governments, and the global cancer community to close gaps in cancer risk awareness between higher and lower socioeconomic groups and the subsequent impact on their...

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas: Present and Future

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel immunotherapies for patients with different types of non-Hodgkin...

Selected ASH Abstracts on Myelodysplastic Syndromes

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for myelodysplastic syndromes (MDS), including the...

Actively Recruiting Clinical Trials for Cervical Cancer

This Clinical Trials Resource Guide lists actively recruiting clinical trials that focus on cervical cancer. They are examining the efficacy of adding nelfinavir to treatment regimens, using atezolizumab as an immunotherapy primer, combining metformin and doxycycline, adjuvant chemotherapy in...

AMA Foundation Launches New Initiative to Address LGBTQ Health Disparities

The American Medical Association Foundation (AMAF) recently announced a new initiative to create a cadre of LGBTQ health specialists through the AMA Foundation LGBTQ Fellowship Program—a national fellowship program to promote best practices and shared outcomes, while improving the quality of LGBTQ ...

gynecologic cancers

Addition of Secondary Surgical Cytoreduction to Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer

As reported in The New England Journal of Medicine by Robert L. Coleman, MD, of MD Anderson Cancer Center, and colleagues, the phase III trial Gynecologic Oncology Group (GOG)-0213 trial has shown no overall survival benefit with secondary surgical cytoreduction followed by chemotherapy with or...

breast cancer

Expert Point of View: Harold J. Burstein, MD, PhD, FASCO

Commenting on Dr. DeMichele’s poster presentation at the 2019 San Antonio Breast Cancer Symposium, Harold J. Burstein, MD, PhD, FASCO, Professor of Medicine at Harvard Medical School and a medical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, told The ASCO...

breast cancer

Real-World Use of Palbociclib and Abemaciclib Explored in Two Studies Based on Electronic Health Records Database

Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors are changing the landscape of the treatment of hormone receptor (HR)-positive/HER2-negative breast cancer. Three CDK4/6 inhibitors are approved by the U.S. Food and Drug Administration—ribociclib, palbociclib, and abemaciclib—as first- or...

leukemia

Dasatinib vs Imatinib in Pediatric Philadelphia Chromosome–Positive ALL

In a Chinese phase III trial reported in JAMA Oncology, Shen et al found that dasatinib was associated was superior event-free survival vs imatinib when combined with intensive chemotherapy in pediatric patients with Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) not receiving...

ASCO’s Inaugural Breakthrough Global Summit Showcased Evolving Technologies Poised to Revolutionize Cancer Care

Unlike ASCO’s Annual Meeting, symposia, and conferences, which highlight the current scientific advances in specific cancers and how they are improving cancer outcomes for the more than 18.1 million people worldwide diagnosed with cancer each year,1 ASCO Breakthrough: A Global Summit for Oncology...

lung cancer

Patient Aid Improved Lung Cancer Screening Informed Decision-Making

In the first comparative clinical trial of lung cancer screening decision aid vs standard educational information, researchers from The University of Texas MD Anderson Cancer Center showed that a decision aid delivered through tobacco quitlines effectively reaches a screening-eligible population...

solid tumors
immunotherapy

Peripheral Blood Lymphocytes and T Cells Targeting TP53 Mutations in Patients With Metastatic Solid Tumors

Although TP53 is the most frequently mutated gene across all cancers and encodes the tumor suppressor p53 protein, TP53-targeted therapies have not demonstrated efficacy beyond in vitro models and immunotherapies targeting mutant TP53 are not currently available. A study by Malekzadeh et al...

gastrointestinal cancer

Does Treating Individuals for H pylori Infection Reduce Gastric Cancer Risk in Those With a Family History of the Disease?

In a large Korean single-center study reported in The New England Journal of Medicine, Choi et al found that eradication of Helicobacter pylori infection was associated with a reduced risk of gastric cancer in individuals with a family history of gastric cancer in first-degree relatives. As stated ...

KEYNOTE-158 Trial: Pembrolizumab Produces Durable Responses in Select Noncolorectal Tumors

As reported in the Journal of Clinical Oncology by Aurelien Marabelle, MD, PhD, of Gustave Roussy, Institut National de la Santé et de la Recherche Médicale, Villejuif, and colleagues, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal high...

leukemia
lymphoma

Expert Point of View: Joshua Brody, MD

Joshua Brody, MD, Director of the Lymphoma Immunotherapy Program at the Icahn School of Medicine at Mount Sinai, New York, commented on where zanubrutinib might fit in once the drug is approved. “The two abstracts presented at ASH 2019 …demonstrated remarkably high response rates, durations of...

leukemia
lymphoma

Two Clinical Trials Show Zanubrutinib Achieves High Response Rates in del(17p) CLL and SLL

The Bruton’s tyrosine kinase inhibitor (BTK) zanubrutinib continues to achieve high overall response rates for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), even in the presence of high-risk cytogenetics, according to findings from two different trials...

prostate cancer

Novel Guideline Addresses the Clinical Utility of Molecular Biomarkers in Localized Prostate Cancer

In men, prostate cancer has the highest incidence of any neoplasm and is the second-leading cause of cancer-related mortality. A plethora of tissue-based biomarkers are available to inform the diagnosis and prognosis for men with newly diagnosed, clinically localized prostate cancer. However, to...

supportive care
integrative oncology

Psilocybin-Assisted Psychotherapy and Cancer-Related Psychiatric Distress

In a study published by Agin-Liebes et al in the Journal of Psychopharmacology, researchers found that psychotherapy involving psilocybin—the active ingredient in “magic” or “psychedelic” mushrooms—may aid in long-term relief from cancer-related psychiatric distress. Study Background and Design An ...

lung cancer
thyroid cancer
myelodysplastic syndromes

FDA Pipeline: Priority Review Granted for Treatment in Lung and Thyroid Cancers

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to a treatment for lung and thyroid cancers with a RET fusion or mutation; gave Breakthrough Therapy designation to a doublet therapy for TP53-mutated myelodysplastic syndromes; and issued an update to their...

sarcoma
immunotherapy

Immunotherapy Combination in Previously Treated Advanced Sarcoma

In a single-institution phase II study reported in JAMA Oncology, Kelly et al found that the combination of talimogene laherparepvec (T-VEC) and pembrolizumab produced durable responses in patients with previously treated advanced sarcoma. As noted by the investigators, T-VEC has been found to...

skin cancer

Risk of CNS Metastasis in Patients With AJCC 8th Edition Stage III Melanoma

A study using data from two major melanoma centers in the United States and Australia, reported in the Journal of Clinical Oncology by Haydu et al, has shown a 5-year cumulative incidence of central nervous system (CNS) metastasis of 15.8% among patients with American Joint Committee on Cancer...

News From the Gastrointestinal Cancers Symposium

The 2020 Gastrointestinal Cancers Symposium took place last weekend, and this week, we’ll take a deeper dive into findings in pancreatic cancer and colorectal cancer. We’ll also review the FDA approval of tazemetostat in epithelioid sarcoma.

breast cancer

When Added to Other Systemic Therapies, Capecitabine Improves Outcomes in Triple-Negative Breast Cancer

Capecitabine is often used to treat breast cancer, but the best use of capecitabine is open for discussion. According to a large meta-analysis of the effects of capecitabine in early breast cancer, capecitabine improves disease-free and overall survival for patients with triple-negative breast...

lung cancer
immunotherapy

Pooled Analysis of Body Mass Index and Overall Survival With Immune Checkpoint Inhibitor Therapy in NSCLC

In a study reported in JAMA Oncology, Kichenadasse et al found that high body mass index was associated with improved overall survival in patients with advanced non–small cell lung cancer (NSCLC) treated with atezolizumab. As noted by the investigators, there are data showing that high BMI is...

prostate cancer
issues in oncology

Equal-Access Health-Care System for African American and White Men With Prostate Cancer

Among men with prostate cancer who received care from the U.S. Department of Veterans Affairs (VA) Health System, an equal-access health-care system, African American men did not have more advanced disease at the time of diagnosis or die earlier than white men, unlike trends seen in the greater...

head and neck cancer
pain management

Gabapentin and Methadone for Patients Undergoing Treatment of Head and Neck Cancer

With nearly all patients who undergo treatment for cancer of the head and neck experiencing oral mucositis, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients—while also reducing the need for opioid painkillers—a team...

issues in oncology

Are Patient-Reported Outcomes Predictive of Survival and Likelihood of Hospitalization?

In a study reported in JCO Oncology Practice, Kerrigan et al found that patient-reported outcomes (PROs), obtained by using the National Cancer Institute (NCI) Patient-Reported Outcomes Measurement Information System–Cancer (PROMIS-Ca) Bank, may be prognostic for outcomes in patients with advanced...

multiple myeloma
immunotherapy

Activity of Anti-BCMA BiTE Molecule AMG 420 in Relapsed or Refractory Multiple Myeloma

In a phase I study reported in the Journal of Clinical Oncology, Max S. Topp, MD, and colleagues found the maximum tolerated dose of the investigational anti–B cell maturation antigen (BCMA) bispecific T-cell engager (BiTE) molecule AMG 420 elicited a high response rate in patients with relapsed or ...

hepatobiliary cancer
immunotherapy

Thomas Yau, MBBS, on Advanced Hepatocellular Carcinoma: CheckMate 040 Trial of Nivolumab, Ipilimumab, and Cabozantinib

Thomas Yau, MBBS, of the University of Hong Kong, discusses this triplet combination, which yielded better responses than doublet combination therapy in patients with advanced liver cancer, but with more severe adverse events and more treatment discontinuations (Abstract 478).

gastrointestinal cancer

Brian M. Wolpin, MD, on Performance of a Blood-Based Test for the Detection of Multiple Cancers

Brian M. Wolpin, MD, of Dana-Farber Cancer Institute, discusses a noninvasive blood test evaluating methylation of circulating free DNA. In his study, the blood test detected multiple gastrointestinal cancers at a sensitivity of approximately 81% and a prespecified specificity of > 99%. It also...

breast cancer

Gabrielle Rocque, MD, MSPH, Followed Three Generations of Doctors Into a Career in Medicine

In 2017, breast cancer expert Gabrielle Rocque, MD, MSPH, received an American Cancer Society Mentored Research Scholar Grant for her work in enhancing shared decision-making for patients with advanced breast cancer. “I come from three generations of physicians,” shared Dr. Rocque. “My father (Dr. ...

lymphoma
immunotherapy

Expert Point of View: Basem M. William, MD, MRCP(UK), FACP

Basem M. William, MD, MRCP(UK), FACP, Director of the T-Cell Lymphoma Program and Member of the Blood and Marrow Transplant Program at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, commented on the...

lymphoma
immunotherapy

CAR T-Cell Therapy Comes to Mantle Cell Lymphoma

Advanced mantle cell lymphoma appears to be a good target for chimeric antigen receptor (CAR) T-cell therapy. Treatment with KTE-X19, an anti-CD19 CAR T-cell product, led to unprecedented outcomes in patients with relapsed or refractory disease in the phase II ZUMA-2 study presented at the 2019 ASH ...

lung cancer

STS 2020: Intraoperative Molecular Imaging Technology Helps Surgeons to Detect NSCLC

A tumor-highlighting technology—OTL38—enhances the visualization of lung cancer tissue, providing surgeons with a significantly better chance of finding and removing more cancer than previously possible, according to a scientific presentation by Gangadharan et al at the Plenary Session of the 56th...

breast cancer
colorectal cancer
legislation
health-care policy

Late-Stage Cancer Diagnoses After Massachusetts Health Insurance Reform Law

Advanced-stage cancer diagnoses declined following health insurance expansion in Massachusetts, likely due to increased access to screening and diagnostic services that identified cancers earlier, according to new research published by Sabik et al in the journal Medical Care. The analysis...

issues in oncology

Ringing a Bell on the Last Day of Radiation Therapy: Helpful or Harmful?

Some patients with cancer celebrate the end of a course of radiation or chemotherapy by ringing a bell. Indeed, many patients say they love the graduation-like ceremony and the sense of closure it gives them. However, a study published by Williams et al in the International Journal of Radiation...

solid tumors
immunotherapy

Dual VEGF and PD-1 Inhibition in Advanced Solid Tumors

In a phase Ib/II trial reported in the Journal of Clinical Oncology, Taylor et al found the combination of the VEGF inhibitor lenvatinib and the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab showed activity across a range of advanced solid tumors. As stated by the authors, there is ...

pancreatic cancer

Danielle S. Bitterman, MD, on Pancreatic Cancer: Noninvasive Genomic Profiling From Plasma ctDNA

Danielle S. Bitterman, MD, of the Harvard University Radiation Oncology Program and Massachusetts General Hospital, discusses an analysis of genomic and clinical data from 97 patients with pancreatic ductal adenocarcinoma with circulating tumor DNA. Mutations were most frequently detected in...

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