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2014 Featured Columnists

The ASCO Post wishes to acknowledge and thank all contributors to the publication during 2014. Here we recognize those who shared their personal thoughts in our Op-Ed department. If you are interested in contributing to The ASCO Post in 2015, write to editor@ASCOPost.com.   Robert Peter Gale, MD,...

colorectal cancer

Personalized Genetic and Environmental Risk Assessment Does Not Increase Use of Colorectal Cancer Screening

Individualized genetic and environmental risk assessment of susceptibility to colorectal cancer does not influence adherence to screening in average-risk persons, according to results from a two-group, randomized, controlled trial. Among patients who received genetic and environmental risk...

leukemia

Obinutuzumab May Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months,...

solid tumors

Predicting Immunogenic Tumor Neoantigens With Combined Mass Spectrometry and Exome Sequencing

Peptides containing tumor somatic mutations are potentially immunogenic if presented on major histocompatibility complex class I molecules (MHC-I), and it has been shown that such mutant peptides act as T-cell epitopes.  In a study reported in Nature, Yadav and colleagues developed an approach...

PD-L1 Expression by Tumor-Infiltrating Cells Associated With Activity of Anti–PD-L1 Antibody in Multiple Cancer Types

Programmed cell death protein ligand 1 (PD-L1) interferes with anticancer immune response by binding programmed PD-1 and B7.1 (CD80), negative regulators of T-cell activation. In a study reported in Nature, Herbst and colleagues showed that treatment with an anti–PD-L1 antibody (MPDL3280A) produced ...

gynecologic cancers

Dual HER2 Targeting Inhibits HER2-Amplified Uterine Serous Carcinoma

In a study reported in Clinical Cancer Research, Groeneweg and colleagues found that dual HER2 targeting showed greater activity than a single agent in HER2-amplified uterine serious carcinoma. In the study, ARK1, ARK2, and SPEC2 cell lines were treated with trastuzumab (Herceptin) or lapatinib...

lung cancer

Lipophilic Bisphosphonate  Plus Rapamycin Active in KRAS-Mutant Lung Cancer

KRAS-mutant lung adenocarcinoma has not been successfully targeted therapeutically. In a study reported in Science Translational Medicine, Xia and colleagues found that the combination of lipophilic bisphosphonates and rapamycin exhibited promising activity in this setting. Lipophilic...

Expect Questions About Cancer Cachexia From Patients and Family Members

Cachexia is estimated to be the immediate cause of death in 20% to 40% of cancer patients,” and by the time of diagnosis, “60% of patients with lung cancer have already experienced a significant weight loss, according to the National Cancer Institute.1 “All of us who have treated these patients...

supportive care
lung cancer
symptom management

Appetite-Enhancing Agent Helps Patients Treated for NSCLC Gain Weight and Lean Body Mass and Feel Better

People have an image of stage III or IV lung cancer patients getting chemotherapy or chemoradiation, and they look terrible; they are losing weight. The fact is, when they respond, they can gain weight,” according to Philip Bonomi, MD, MS. He is the lead author of a phase III study showing that the ...

hematologic malignancies

FDA Approves Ruxolitinib to Treat Patients With Polycythemia Vera

The U.S. Food and Drug Administration (FDA) approved a new use for ruxolitinib (Jakafi) to treat patients with polycythemia vera, a chronic type of bone marrow disease. Ruxolitinib, a JAK inhibitor, is the first drug approved by the FDA for this condition. Polycythemia vera occurs when too many red ...

issues in oncology

The Wedding Picture

The following essay by Fadlo R. Khuri, MD, FACP, is excerpted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories (May 2014), coedited by Stan Winokur, MD, and Vincent Coppola. The book is available on Amazon.com and thebigcasino.org.   Life and hope are why we go...

Additional Articles of Note

Adjuvant Bisphosphonates in Early Breast Cancer: Practice-Changing Findings January 15, 2014, Volume 5, Issue 1 Visit http://bit.ly/1rUM8CS HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen January 15, 2014, Volume 5, Issue 1 Visit http://bit.ly/1tA6UZ4...

Top 10 Articles From The ASCO Post in 2014

The following list presents those articles published in 2014 that were observed most often by visitors to ASCOPost.com, as measured by the number of views.a To view the full version of the articles listed below, visit ASCOPost.com and enter the URL provided below each entry. 1. Continuous...

2014 Oncology Meetings

JANUARY 2015 Melanoma 2015: 25th Annual Cutaneous Malignancy UpdateJanuary 10-11 • San Diego, California For more information: www.scripps.org/events/melanoma-annual-cutaneous-malignancy-update-january-10-2015 7th Breast Gynecological International Cancer ConferenceJanuary 15-16 • Cairo, Egypt For ...

sarcoma

Clinical Trials Actively Recruiting Patients With Soft-Tissue Sarcomas

The information contained in this Clinical Trials Resource Guide includes details of actively recruiting clinical studies of children and adults with various types of soft-tissue sarcoma, including non-rhabdomyosarcoma, Ewing sarcoma, gastrointestinal stromal tumor, and Kaposi sarcoma. The studies...

leukemia

FDA Approves Blinatumomab to Treat Rare Form of Acute Lymphoblastic Leukemia

The U.S. Food and Drug Administration (FDA) today granted accelerated approval to blinatumomab (Blincyto) for the treatment of patients with Philadelphia chromosome–negative, relapsed or refractory precursor B-cell acute lymphoblastic leukemia (B-cell ALL). Blinatumomab is a bispecific...

integrative oncology

Aloe Vera

The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

palliative care

Debate Over Legalizing Physician-Assisted Death for the Terminally Ill

On November 1, 2014, 29-year-old Brittany Maynard ended her life through physician-assisted death, reigniting the controversy surrounding Death With Dignity laws, which allow physicians to prescribe life-ending drugs to terminally ill patients. Diagnosed with glioblastoma multiforme in January, Ms. ...

head and neck cancer

Antacids Linked to Better Survival in Patients With Head and Neck Cancer

Patients with head and neck cancer who used antacid medicines to control acid reflux had better overall survival, according to a study from the University of Michigan Comprehensive Cancer Center. Results of the study were published in Cancer Prevention Research.1 Reflux can be a common side effect...

palliative care

Cancer Care Incomplete Without Palliative Care Integration

ASCO recognizes that an array of efforts are needed to fully integrate palliative care into the cancer care continuum, and the Society is committed to facilitating the integration of palliative cancer care into existing health-care systems worldwide in order to realize the vision of comprehensive...

colorectal cancer

Conquer Cancer Foundation and Michael’s Mission Work Together to Conquer Colorectal Cancer

"Nobody tells a 28 year old to get a colonoscopy.” It’s the sad but true reality that many young adults may be at risk for colorectal cancer. Unfortunately, many people, young adults in particular, are not aware of the risk factors and do not get screened early enough to catch the disease when it...

health-care policy

Policy Issues in Molecularly Targeted Therapy: The Science, the Money, the Applications

In the past decade, much new knowledge about the molecular underpinnings of cancer has accumulated, and the array of molecular aberrations in each individual tumor can be assessed through genomic sequencing and other tests. The rationale for and feasibility of developing molecularly targeted...

symptom management

Benefits of Exercise for Relieving Fatigue in Cancer Survivors

Fatigue is such a common—and ongoing—problem among cancer survivors, last spring, ASCO published a clinical practice guideline1 to address screening, assessment, and treatment approaches for the management of fatigue after patients have completed treatment. Among the strategies included in the...

skin cancer

Getting the Most Out of Ipilimumab in Melanoma

Ipilimumab (Yervoy) was first approved by the U.S. Food and Drug Administration (FDA) in 2011 on the basis of an improvement in overall survival compared with gp100 vaccine in patients with advanced melanoma.1 Response rates with ipilimumab have been modest at best—10% to 15% using 3 mg/kg and 15%...

skin cancer

Phase II Study Shows Improved Survival With Addition of Sargramostim to Ipilimumab in Metastatic Melanoma

Use of the granulocyte-macrophage colony-stimulating factor (GM-CSF) sargramostim (Leukine) together with the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab (Yervoy) prolonged overall survival but not progression-free survival in patients with metastatic melanoma,...

lung cancer

Moving a Mountain: Crizotinib in ROS1-Rearranged NSCLC

It was thousands of years ago in China. An elderly man was unhappy with the mountain that embraced his seaside village. He would need to walk for hours before he could reach the nearest town. So, as the old fable goes, he set his mind to move the mountain. Every day, he dug up basketfuls of rocks...

lung cancer

Crizotinib Is Highly Active in ROS1-Rearranged NSCLC

Crizotinib (Xalkori) produced a high response rate and durable responses in patients with ROS1-rearranged non–small cell lung cancer (NSCLC), according to a study reported in The New England Journal of Medicine.1 Lead authors Alice T. Shaw, MD, PhD, of Massachusetts General Hospital Cancer Center,...

survivorship

ASCO Clinical Expert Statement on Cancer Survivorship Care Planning

Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete them, the lack of role clarity, and the lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship Care Planning...

Expert Point of View: Justin Gainor, MD

This is a very exciting time in lung cancer. Immunotherapy is extremely promising,” stated Justin Gainor, MD, a thoracic oncologist at Massachusetts General Hospital in Boston. The promise of immunotherapy extends to a broad patient population. Targeted treatments have transformed the lives of...

pancreatic cancer

Choice for Metastatic Pancreatic Cancer: FOLFIRINOX or Gemcitabine/Nab-Paclitaxel?

The choice between FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) vs the combination of gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for first-line treatment of metastatic pancreatic cancer is not much of a contest, judging by a discussion of...

skin cancer

New Serologic Assay May Help Predict Recurrences in Merkel Cell Carcinoma

A new and inexpensive serologic assay may help to predict recurrences of Merkel cell carcinoma, according to Paul Nghiem, MD, PhD, the Michael Piepkorn Endowed Chair in Dermatology Research at the University of Washington, Seattle, who helped develop the test.1 Dr. Nghiem and other experts in...

skin cancer

Hedgehog Inhibitors Can Be Life-Altering in Patients With Advanced Basal Cell Carcinoma

What advanced basal cell carcinomas lack in frequency, they make up for in morbidity, and for these challenging patients, the hedgehog inhibitors have changed lives, according to experts at the 3rd Annual World Cutaneous Malignancies Congress, held recently in San Francisco. “The majority of basal...

Expert Point of View: Ethan Basch, MD

Formal discussant of the patient-reported outcomes study by Smith et al presented at the Quality Care Symposium in Boston, Ethan Basch, MD, Director of the Cancer Outcomes Research Program at the University of North Carolina School of Medicine in Chapel Hill, praised the research for its important...

lung cancer

Lung Cancer Expert Offers Recommendations for Treating Toxicities Associated With Targeted Therapies

Clearly life as a thoracic oncologist has changed. Our paradigm for giving one-size-fits-all chemotherapy seems a bit dated, as we now are learning that there are multiple targets that we can treat effectively with the right drugs,” Jyoti D. Patel, MD, Associate Professor of Medicine at...

lung cancer
health-care policy

CMS Issues Preliminary Decision to Cover Annual Lung Cancer Screening

In a long-awaited decision, the Centers for Medicare & Medicaid Services (CMS) has issued a preliminary proposal to cover annual lung cancer screening with low-dose computed tomography for appropriate beneficiaries following counseling and a shared–decision-making visit with a qualified...

leukemia

Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?

“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918)   Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...

lymphoma

PD-1 Blockade Moves Into Hematology

The promise of the programmed death receptor-1 (PD-1) inhibitors seen in solid tumors, especially melanoma, may hold true for at least one hematologic malignancy, according to studies presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition. At a press briefing, data ...

palliative care

Better Studies Needed to Dispel Confusion Over When to Refer a Patient to Hospice

I read the article on “Private Payer and Academic Center Data Capture Inappropriate Use of End-of Life Care” (The ASCO Post, December 15, 2014, page 11). The data highlight Dr. Deborah Schrag’s notion that there is “ample evidence of overuse of intensive care at the end of life.” However, there is...

breast cancer

Mammographic Density Is Highly Heritable, Possibly Explaining the Familial Aggregation of Breast Cancer

Using a fully automated method to ascertain volumetric mammographic density, a study conducted by the Karolinska Mammography (KARMA) project for risk prediction of breast cancer in Sweden confirmed the high heritability of mammographic density, although estimates were weaker for absolute than for...

leukemia

Patients With Chronic Lymphocytic Leukemia Who Progress After Front-line Treatment May Be Candidates for Novel Noncytotoxic Therapies

Although patients who relapse within 3 years of front-line fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) therapy have poor survival when treated with conventional salvage regimens, these patients may be candidates for novel noncytotoxic therapies, according to an analysis of extended...

colorectal cancer

AJCC Cancer Staging System Is Most Accurate Measuring Response to Chemoradiation in Locally Advanced Rectal Cancer

When classifying response to chemoradiation among patients with locally advanced rectal cancer, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (7th edition) system “is most accurate and should be adopted as the standard,” Attaphorn Trakarnsanga, MD, and colleagues at Memorial...

Citing Guidelines May Reassure Patients

Whether deviations from treatment guidelines are warranted to provide optimal personalized care, or should be financially penalized for straying from evidence-based care, has raised questions among insurers and physicians and caused a stir in the press. In general, however, patients with cancer are ...

issues in oncology

Physicians Need to Maintain Flexibility to Deviate From Treatment Guidelines Without Financial Penalties

With the provocative headline, “How Medical Care Is Being Corrupted,” an op-ed piece in The New York Times argued that “financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients.”1 The article warned that insurers,...

gynecologic cancers

Electro-Gynecology, Philadelphia, 1883

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

breast cancer

Man With Tumor of the Breast, Albumen Print, Paris, 1873

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

gynecologic cancers

Ovarian Cancer Has Taught Me to Be Fearless

In 2013, I was at the top of my professional game. I was a lead performer in the hit Broadway show Motown: The Musical, playing singing legend Diana Ross, which earned me a Tony Award nomination. Performing eight shows a week is exhausting, but I had no problem meeting the physical demands of the...

lymphoma

Life Is Like Riding a Bicycle

The following essay by Bruce D. Cheson, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   The ride...

integrative oncology

The Best of SIO

The following five abstracts, which include four clinical studies and one basic research study, were named the top abstracts at the 2014 International Conference of the Society for Integrative Oncology. Therapeutic Effects of Lyophilized Leech Saliva Extract Hassona MDH, Ammar AE, Gao TY, et al: In ...

gynecologic cancers

Olaparib for BRCA-Mutated Previously Treated Advanced Ovarian Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On December 19, 2014, olaparib (Lynparza) was granted accelerated...

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