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lymphoma
immunotherapy

Brentuximab Vedotin in Previously Untreated Stage III or IV Classical Hodgkin Lymphoma

On March 20, 2018, brentuximab vedotin (Adcetris) was approved for the treatment of adult patients with previously untreated stage III or IV classical Hodgkin lymphoma in combination with chemotherapy.1,2 Supporting Efficacy Data Approval was based on the findings of the open-label phase III...

issues in oncology
cost of care
immunotherapy

Weighing the Cost and Value of CAR T-Cell Therapy

This past year’s approval by the U.S. Food and Drug Administration (FDA) of two chimeric antigen receptor (CAR) T-cell therapies heralded a new era in both effective cancer treatments and the most expensive cancer drugs ever. Tisagenlecleucel (Kymriah) was initially approved for the treatment of...

multiple myeloma
immunotherapy

FDA Approves Daratumumab/VMP Combination for Newly Diagnosed Multiple Myeloma

On May 7, the U.S. Food and Drug Administration(FDA) approved daratumumab (Darzalex) in combination with bortezomib (Velcade), a proteasome inhibitor; melphalan, an alkylating agent; and prednisone—VMP—for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for...

issues in oncology

Here’s How ASCO Is Joining With Other Organizations to Reduce Obesity and Cancer Rates

GUEST EDITOR Prevention in Oncology is guest edited by Jennifer A. Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber...

solid tumors
breast cancer

Endocrine Therapy: An Important Treatment Limited by Major Challenges

“Endocrine therapy remains the most effective and least toxic treatment for breast cancer, but we have many problems to solve. And there will have to be many different solutions,” according to George W. Sledge, MD, FASCO, Professor of Medicine and Chief of the Division of Oncology at Stanford...

Expert Point of View: William M. Sikov, MD and Sunil Verma, MD

The ASCO Post obtained comments about the Persephone trial results from two breast cancer experts. William M. Sikov, MD, is Associate Director of Clinical Research at the Program in Women’s Oncology at Women and Infants Hospital of Rhode Island and Associate Professor of Medicine and of...

lung cancer

Researchers Identify Most Accurate Risk-Prediction Models for Lung Cancer Screening in Ever-Smokers

Recent lung cancer screening guidelines from the National Comprehensive Cancer Network(®) permit the use of risk models to refer ever-smokers for screening. However, different models select different screening populations and the performance of each model in selecting ever-smokers is...

issues in oncology

Now More Than Ever, the Oncology Pharmacist Can Play a Variety of Roles on the Health-Care Team

Susannah E. Koontz, PharmD, BCOP, FHOPA, is a consultant for clinical pharmacy services, research, and education in the areas of pediatric hematology/oncology, stem cell transplantation, and cellular therapy. She has held positions at the Children’s Cancer Hospital at The University of Texas MD...

health-care policy

COA Practice Impact Report Details Consolidation, Shift of Cancer Care System Into Hospital Setting

THE COMMUNITY ONCOLOGY Alliance (COA) has released the 2018 Community Oncology Practice Impact Report,1 which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

skin cancer

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update

AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional...

head and neck cancer

Circulating Tumor DNA May Guide Treatment Intensity in Advanced HPV-Associated Head and Neck Cancers

A MULTI-INSTITUTIONAL analysis of circulating tumor DNA extracted from the plasma of patients has shown that human papillomavirus type 16 (HPV16) DNA is detectable in the majority of cases of favorable-risk HPV-associated oropharyngeal squamous cell carcinoma and may be a clinically useful...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Improves Relapse-Free Survival in High-Risk Stage III Melanoma

ADJUVANT THERAPY with pembrolizumab (Keytruda) significantly prolonged recurrence-free survival compared with placebo for patients with resected high-risk stage III melanoma, according to the results of the EORTC 1325/KEYNOTE-054 trial.1 Patients who received pembrolizumab had a 43% reduction in...

leukemia
genomics/genetics

Minimal Residual Disease in Acute Myeloid Leukemia: Mutation Matters

A RECENT article in The New England Journal of Medicine explored the nuances of minimal/measurable residual disease testing after induction treatment of acute myeloid leukemia (AML)1 and David P. Steensma, MD, and Benjamin L. Ebert, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical...

lung cancer
immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

solid tumors
skin cancer

FDA Approves Drug Combination for Adjuvant Treatment of BRAF V600–Mutant Melanoma

On April 30, 2018, the U.S. Food and Drug Administration (FDA) approved dabrafenib (Tafinlar) in combination with trametinib (Mekinist) for the adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations, as detected by an FDA-approved test, and lymph node involvement following...

supportive care
integrative oncology

Chamomile

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, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, focus attention on chamomile ...

issues in oncology
legislation

Decision Aids Reflect Patients’ Values and Preferences for Care: So Why Aren’t More Oncologists Using Them?

Overwhelming evidence shows that patient decision aids, such as educational booklets, videos, or Web-based tools that take into account patients’ values and personal preferences, hold enormous promise for improving the informed consent process. Patient decision aids both reduce unwanted medical...

skin cancer
immunotherapy

Nivolumab in Adjuvant Treatment of Melanoma

On December 20, 2017, nivolumab (Opdivo) was granted regular approval for adjuvant treatment of patients with melanoma with lymph node involvement or metastatic disease who have undergone complete resection.1,2 Nivolumab was previously approved for the treatment of patients with unresectable or...

solid tumors
prostate cancer

Should We Treat Rising PSA in Men With Castrate Androgen Levels?

In rapid succession, the SPARTAN study results were presented at the 2018 Genitourinary Cancers Symposium, the data were published in The New England Journal of Medicine,1 and the drug apalutamide -(Erleada) was approved by the U.S. Food and Drug Administration (FDA) for men with previously...

supportive care
palliative care

Using Video Decision-Support Tools to Facilitate End-of-Life Discussions With Patients

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. Research shows that...

lung cancer
prostate cancer

By 2030, Prostate and Lung Cancers Are Expected to Be the Most Common Cancer Types Among HIV-Infected Adults

While effective antiretroviral therapy, which suppresses HIV replication and improves immune function, has resulted in increased longevity for people living with HIV and reduced the risk of certain cancers, including Kaposi sarcoma and non-Hodgkin lymphoma, other cancers are expected to become more ...

integrative oncology

Massage Therapy for Patients With Cancer

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, Ting Bao, MD, DABMA, MS, reviews the current data on the use of massage to...

multiple myeloma

Updated International Myeloma Working Group Criteria: Diagnostic Challenges

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Landgren review the underlying data that shaped the updated International Myeloma Working Group (IMWG) diagnostic criteria for...

lymphoma
immunotherapy

Axicabtagene Ciloleucel CAR T-Cell Therapy Active in Refractory Large B-Cell Lymphoma

As reported at the 2017 American Society of Hematology (ASH) Meeting & Exposition and in The New England Journal of Medicine by Sattva S. Neelapu, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase II trial has shown high activity of autologous anti-CD19 chimeric...

solid tumors
lung cancer
issues in oncology

Enormous Cost of Failure to Screen Heavy Smokers for Lung Nodules

In 2011 the American College of Radiology Imaging Network (ACRIN) group published its publicly funded study of three annual screening chest computed tomography (CT) scans among heavy smokers aged 55 to 74.1 The results remain the first and only screening study for any cancer demonstrating a...

hematologic malignancies
lymphoma
immunotherapy

Promise and Challenges of CAR T-Cell Therapy for Diffuse Large B-Cell Lymphoma: ZUMA-1 Trial Results

Advancing therapeutics and augmenting curability in diffuse large B-cell lymphoma (DLBCL) have been very challenging. Although many novel approaches have offered promise and continue to be developed, we have not yet identified a clearly superior approach to R-CHOP (rituximab [Rituxan],...

breast cancer
immunotherapy

2018 Treatment Algorithm for Metastatic HER2-Positive Breast Cancer

How should clinicians position anti-HER2 agents and also incorporate endocrine therapies in the treatment of metastatic HER2-positive breast cancer? At the 2018 Miami Breast Cancer Conference, this question was explored by Sunil Verma, MD, Medical Director of the Tom Baker Cancer Center and...

issues in oncology

How to Respond to a Patient’s Discriminatory Request for a Different Clinician

Some patients may make discriminatory requests for a different clinician for their health care.1-5 These individuals may want to avoid treatment with clinicians of a certain race, religion, gender, sexual orientation, or national origin. Oncologists are not exempt from this type of patient...

lymphoma
immunotherapy

Is CAR T-Cell Therapy Setting a New Standard of Care in Lymphoma?

Data presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition on the longer-term follow-up analysis of results from the ZUMA-1 trial investigating the effectiveness of axicabtagene ciloleucel (Yescarta) in patients with refractory non-Hodgkin lymphoma (NHL) showed...

lymphoma
immunotherapy

FDA Expands Approval of Brentuximab Vedotin in Classical Hodgkin Lymphoma

ON MARCH 20, the U.S. Food and Drug Administration (FDA) approved brentuximab vedotin (Adcetris), an antibody-drug conjugate, to treat adult patients with previously untreated stage III or IV classical Hodgkin lymphoma in combination with chemotherapy. Brentuximab vedotin combines an antibody and...

breast cancer

How Will ctDNA Assays Aid in Managing Breast Cancer?

CIRCULATING TUMOR DNA (ctDNA) assays are now commercially available for use in lung cancer and melanoma, where they can identify the presence of specific mutations that drive treatment selection. In breast cancer, ctDNA remains more of a research tool, but this is poised to change.  At the 2018...

head and neck cancer

Intratumor Heterogeneity of Head and Neck Cancers May Have Therapeutic Implications

A RETROSPECTIVE STUDY of The Cancer Genome Atlas may have therapy-specific implications for patients with head and neck squamous cell carcinoma, according to data presented at the 2018 Multidisciplinary Head and Neck Cancers Symposium.1 This first analysis of the relationship between intratumor...

solid tumors
breast cancer

Extended Duration of Aromatase Inhibitors Need Not Be Very Long

At the 2017 San Antonio Breast Cancer Symposium (SABCS), Michael Gnant, MD, FACS, of the Medical University of Vienna presented the 9-year median follow-up of a trial looking at the length of extended aromatase inhibitor therapy. At least four other recently presented or published trials have...

supportive care
integrative oncology

Ashwagandha

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, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, present information on...

issues in oncology
survivorship

Impact of Lifestyle Choices on Outcomes in Survivors of Gastrointestinal Cancers

Physical inactivity among adult survivors of gastrointestinal cancers was tied to poor health-related quality of life, according to researchers at the American Psychosocial Oncology Society (APOS) Annual Meeting.1 Also, physical inactivity (Chi-square = 5.605, P = .018) and alcohol use (Chi-square ...

leukemia
immunotherapy

Trivalent CAR T-Cell Design May Enhance Antitumor Efficacy in Acute Lymphoblastic Leukemia

A novel approach to chimeric antigen receptor (CAR) T-cell therapy seems to effectively target acute lymphoblastic leukemia (ALL) cells with varying antigen profiles and may help to overcome antigen escape, seen with CD19-targeted therapy. According to data presented at the 2018 ASCO-SITC Clinical...

prostate cancer
immunotherapy

Small Study Evaluates Novel Combination in Metastatic Prostate Cancer

The combination of the poly ADP-ribose polymerase (PARP) inhibitor olaparib (Lynparza) and the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) produced positive preliminary results in men with metastatic, castration-resistant prostate cancer previously treated with...

bladder cancer
immunotherapy

Pembrolizumab Survival Advantage Upheld in Advanced Urothelial Carcinoma

Patients with recurrent urothelial cancer had sustained improvement in overall survival at 2 years after they received second-line treatment with pembrolizumab (Keytruda) vs chemotherapy, according to an updated survival analysis of the phase III KEYNOTE-045 trial presented at the 2018...

hematologic malignancies
lymphoma
immunotherapy

CAR T-Cell Therapy in Refractory B-Cell Lymphomas

  As reported at the 2017 American Society of Hematology Annual Meeting & Exposition and in The New England Journal of Medicine, Stephen J. Schuster, MD, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues found that chimeric antigen receptor (CAR) T-cell...

hematologic malignancies

Answers to Hematology Expert Review Questions

GUEST EDITORS: Dr. Abutalib is Assistant Director, Hematology and Hematopoietic Cell Transplantation Director, Hematopoietic Cell Transplant Apheresis Service, Cancer Treatment Centers of America, Zion, Illinois, Editor-in-Chief, Advances in Cell & Gene Therapy. Dr. Medeiros is Professor and...

issues in oncology

Legal Duties of Clinicians When Terminally Ill Patients With Cancer or Their Surrogates Insist on ‘Futile’ Treatment

Law and Ethics in Oncology explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy. For years, ASCO and other medical societies have...

issues in oncology
survivorship

It Starts With a Discussion: ASCO Guideline on Interventions to Address Sexual Problems in People With Cancer

Dr. Katz is a certified sexuality counselor at CancerCare Manitoba, Canada. SEXUALITY AND SEXUAL functioning are important to cancer survivors, and considering the significant number of survivors, this is an issue that should not be ignored. In a survey of cancer survivors who had completed...

lung cancer

Osimertinib: A New Standard of Care in Initial Treatment of EGFR-Mutant NSCLC

Dr. Ramalingam is Professor of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute, Atlanta. MUTATIONS IN the epidermal growth factor receptor (EGFR) gene were discovered in 2004. These mutations, localized most commonly to exon 19 or 21, vary in...

lung cancer

Osimertinib Improves Progression-Free Survival vs Standard EGFR Inhibitors in EGFR-Mutant NSCLC

AS REPORTED in The New England Journal of Medicine by Jean-Charles Soria, MD, PhD, of Gustave Roussy Cancer Campus and University Paris-Sud, and colleagues, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor...

supportive care
integrative oncology

Acupuncture for the Management of Chemotherapy-Induced Peripheral Neuropathy

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, Ting Bao, MD, DABMA, MS, reviews the current data on the use of acupuncture...

solid tumors
gastrointestinal cancer

Lutetium Lu-177 Dotatate in Gastroenteropancreatic Neuroendocrine Tumors

On January 26, 2018, the radiolabeled somatostatin analog lutetium Lu-177 dotatate (Lutathera) was approved for the treatment of somatostatin receptor–positive gastroenteropancreatic neuroendocrine tumors, including foregut, midgut, and hindgut neuroendocrine tumors, in adults.1,2 Supporting...

prostate cancer

Apalutamide, Enzalutamide Improve Metastasis-Free Survival in Nonmetastatic Castrate-Resistant Prostate Cancer

IN TWO SEPARATE TRIALS presented at the 2018 Genitourinary Cancers Symposium, apalutamide and enzalutamide (Xtandi), respectively, reduced the risk of metastasis and prolonged metastasis-free survival in men with high-risk nonmetastatic castrate-resistant prostate cancer. In the SPARTAN trial,1,2...

prostate cancer

New Agents for Initial Treatment of Metastatic Prostate Cancer: A New Standard of Care?

FOR DECADES, the status of metastatic prostate cancer trials was not particularly exciting. With an absence of high-impact novel agents, the focus of cancer trial groups was on the improvement of standard care. Well-crafted, large trials of hormonal therapy demonstrated the utility of combined...

cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

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