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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...

issues in oncology

Providing Cancer Treatment Without Patient Consent

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. Increasingly, across the United States, hospitals are...

solid tumors
breast cancer

Ovarian Function Suppression During and After Chemotherapy Valid for Some Patients With Early Breast Cancer

Temporary ovarian suppression during chemotherapy as a means of preserving ovarian function and fertility in young women with early breast cancer is controversial. An eagerly awaited meta-analysis including individual patient data from five randomized controlled trials found that the use of...

solid tumors
pancreatic cancer

LAPACT Trial Confirms Efficacy of Nab-Paclitaxel Plus Gemcitabine as Induction Therapy in Pancreatic Cancer

Patients newly diagnosed with locally advanced pancreatic cancer who received induction therapy with nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) and gemcitabine achieved a time to treatment failure and median progression-free survival that exceeded the protocol-specified target by more...

EXPERT POINT OF VIEW: Douglas Corley, MD, PhD and Nancy Baxter, MD

In a discussion of the study, Douglas Corley, MD, PhD, of the Division of Research at Kaiser Permanente, San Francisco Medical Center, California, said it remains unclear whether blood tests can improve the early detection of cancer, though such an approach would be welcomed. “We are getting closer ...

hematologic malignancies
lymphoma

Releasing Follicular Lymphoma From the Curse of Frankenstein

In the December 10, 2017, issue of The ASCO Post, I authored an article in which I raised the possibility of curing follicular lymphoma without the dreaded chemotherapy. Clearly, no good deed goes unpunished: My good friend and The ASCO Post’s editor Jim Armitage, MD, challenged me to defend that...

solid tumors
head and neck cancer

Laryngeal Preservation: All Patients Need a Voice

Following the publication of two landmark studies in the United States,1,2 laryngeal preservation with combined chemoradiotherapy has become standard practice as opposed to laryngectomy for patients with locally advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study...

bladder cancer
immunotherapy

Avelumab in Advanced Urothelial Carcinoma: Further Study Needed to Clarify its Role

AS REVIEWED in this issue of The ASCO Post, Patel and colleagues have presented data from the phase I JAVELIN study evaluating avelumab (Bavencio) in platinum-refractory patients with advanced urothelial carcinoma.1 The drug is active with durable responses when compared with historical...

breast cancer
immunotherapy

Trastuzumab for 9 Weeks Fails to Show Noninferiority in HER2-Positive Breast Cancer

ANOTHER TRIAL has validated that 1 year of adjuvant trastuzumab (Herceptin) remains the standard in HER2-positive breast cancer, but the margin of difference, compared with just 9 weeks of the drug, was slim, based on the findings of the phase III SOLD trial reported at the 2017 San Antonio Breast...

gastroesophageal cancer

Possible Link Between Drinking Hot Tea and Increased Chance of Esophageal Cancer in High-Risk Individuals

Esophageal cancer is the eighth most common cancer worldwide, with an estimated 456,000 new cases in 2012, and the sixth most common cause of death from cancer with an estimated 400,000 deaths, according to data from GLOBOCAN, which provides statistics on the incidence and mortality of cancer...

colorectal cancer

EXPERT POINT OF VIEW: Zsofia Kinga Stadler, MD

DISCUSSANT ZSOFIA KINGA STADLER, MD, of Memorial Sloan Kettering Cancer Center, found the nivolumab (Opdivo)/ipilimumab (Yervoy) combination results very encouraging but was also impressed with the monotherapy arm. Both approaches are significant advances in treatment, she said.  “The treatment of ...

solid tumors
gastrointestinal cancer

FDA Approves Radiopharmaceutical for Rare Gastrointestinal Cancers

On January 26, 2018, the U.S. Food and Drug Administration (FDA) approved lutetium Lu-177 dotatate (Lutathera) for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The drug is indicated for adult patients with somatostatin receptor–positive GEP-NETs. GEP-NETs can be...

hematologic malignancies
leukemia
immunotherapy

Blinatumomab in Relapsed or Refractory B-Cell Precursor ALL

On July 11, 2017, blinatumomab (Blincyto) was approved for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) in adults and children.1,2 Blinatumomab received accelerated approval in December 2014 for the treatment of Philadelphia chromosome (Ph)-negative...

genomics/genetics
issues in oncology

Making Personalized Medicine a Reality for More Patients With Cancer

  This past September, Olivier Elemento, PhD, Associate Director of the Institute for Computational Biomedicine and Director of the Laboratory of Cancer Systems Biology at Weill Cornell Medicine in New York, was named Director of Weill Cornell’s Englander Institute for Precision Medicine. In this...

supportive care
integrative oncology

The State of Integrative Oncology: A New Era

Now that we have entered 2018, let’s take a moment to reflect on how far we have come and what lies ahead in integrative oncology care. Overview To cope with the physical, emotional, and spiritual effects of cancer, and in search of relief from symptoms that their conventional treatments have not...

head and neck cancer

Plasma Epstein-Barr Virus DNA Screening for Nasopharyngeal Cancer

In a Hong Kong study reported in The New England Journal of Medicine, K.C. Allen Chan, MBBS, PhD, MRCP, FRCPA, FHKCPath, FHMAM, of The Chinese University of Hong Kong, Department of Chemical Pathology, and colleagues found that screening for circulating cell-free Epstein-Barr virus (EBV) DNA is...

palliative care

Working Together to Help Pediatric Patients With Cancer Live and Live Well

While many patients with cancer can benefit from palliative care to ease symptoms from the disease or its treatment, for children with cancer, especially critically ill children, palliative care can provide an additional layer of medical and emotional support for both young patients and their...

solid tumors
lung cancer
immunotherapy

Durvalumab Takes a Giant Leap Into Stage III NSCLC

Immune checkpoint inhibitors have had a dramatic impact on survival for patients with stage IV non–small cell lung cancer (NSCLC), with whispers that a cure might be achieved in a subset of patients. In typical fashion, active new agents are evaluated in earlier stages of disease. Stage III NSCLC...

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