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Old and New Perspectives on the Theory of Cancer

BOOKMARK Title: Tripping Over the Truth: How the Metabolic Theory of Cancer Is Overturning One of Medicine’s Most Entrenched ParadigmsAuthor: Travis Christofferson, MSPublisher: Chelsea Green PublishingPublication Date: February 2017Price: $24.95, hardcover; 288 pages Bringing a book to market is...

solid tumors
pancreatic cancer

Achieving One’s Childhood Dreams While Facing Pancreatic Cancer

BOOMARK Title: The Last LectureAuthor: Randy Pausch with Jeffrey ZaslowPublisher: HyperionDate: April 2008Price: $21.95, hardcover; 206 pages Faced with imminent death, how does one chose to live out the remainder of one’s life? Such is the question at the heart of The Last Lecture, a memoir...

Gratitude

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

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

solid tumors

Immunotherapy Has Indelibly Changed the Treatment Paradigm in Urothelial Carcinoma

Cisplatin-based combination chemotherapy is the preferred first-line therapy for metastatic urothelial cancer and the only treatment shown to improve survival in patients with previously untreated disease for many years. This chemotherapy also has proven to be beneficial in the neoadjuvant and...

supportive care
palliative care

Walther Cancer Foundation Endows New ASCO Special Award and Lecture for Palliative and Supportive Care

The Walther Cancer Foundation, Inc., a private foundation based in Indianapolis, Indiana, has endowed a new ASCO award and lecture bearing its name to be presented annually at the Palliative and Supportive Care in Oncology Symposium. This grant represents a new foray for the foundation as it...

hematologic malignancies
lymphoma

Follicular Lymphoma: Is the Road to Cure Paved With Gallium?

The roadside along the path to curing follicular lymphoma is riddled with the debris of failed cytotoxic regimens. For decades, clinical trials unsuccessfully pitted various chemotherapy combinations against each other. It took but a single, noncytotoxic molecule, rituximab (Rituxan), to forever...

Expert Point of View: Michael Boyer, MBBS, PhD

Formal discussant of this trial, Michael Boyer, MBBS, PhD, a medical oncologist at Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia, was enthusiastic about these results, with the caveat that overall survival data are needed. “Unresectable stage III non–small cell lung...

breast cancer

SABCS 2017: Temporary Ovarian Suppression With Hormone Analog May Preserve Fertility During Breast Cancer Chemotherapy

Meta-analysis of individual patient data from five randomized clinical trials provided a high level of evidence that treatment with a gonadotropin-releasing hormone analog (GnRHa) could safely and effectively protect ovarian function and potentially preserve fertility in premenopausal women...

hematologic malignancies
multiple myeloma

Evidence-Based Support for Triplet Therapies in Multiple Myeloma

Over the past 15 years, multiple myeloma has garnered among the highest number of regulatory approvals by the U.S. Food and Drug Administration (FDA) for the management of all phases of the disease. This fast-expanding repertoire of treatment options has pushed the median survival of multiple...

breast cancer

SABCS 2017: Increasing the Dose Intensity of Chemotherapy May Lower the Risk of Breast Cancer Recurrence and Death

Increasing the dose intensity of chemotherapy—by either shortening the intervals between the cycles or by sequential administration instead of concurrent administration of the drugs—reduced the risk of early-stage breast cancer recurrence and death compared with standard chemotherapy...

gastroesophageal cancer

Oral Microbiota Indicates Possible Link Between Periodontal Disease and Esophageal Cancer

An analysis of bacteria present in the mouth showed that some types of bacteria that lead to periodontal disease were associated with higher risk of esophageal cancer, according to a study published by Peters et al in Cancer Research. Esophageal cancer is the eighth most common cancer and the...

leukemia

Patients With CLL May Be Willing to Trade Treatment Efficacy for Reduced Side Effects

When choosing their preferred treatment, patients with chronic lymphocytic leukemia (CLL) place the highest value on treatments that deliver the longest progression-free survival, but they are willing to swap some drug efficacy for a reduced risk of serious adverse events, according to a study...

prostate cancer

Health-Related Quality of Life With Immediate vs Delayed ADT in Prostate Cancer

In a health-related quality-of-life study among patients in the phase III TOAD trial, immediate vs delayed androgen-deprivation therapy (ADT) was associated with early worsening of androgen-deprivation therapy–related symptoms but few other comparative adverse effects on functioning or quality of...

cns cancers

Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

MORE THAN A QUARTER of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 and the prodrug of the chemotherapy fluorouracil (5-FU), Toca FC, were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial, Toca ...

issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

issues in oncology
supportive care

Helping Oncologists to Become Better Communicators With Their Patients

Timothy Gilligan, MD, FASCO, Co-Chair of ASCO’s Expert Panel on Patient-Physician Communications Guideline and Vice-Chair for Education and Associate Professor of Medicine at the Cleveland Clinic Taussig Cancer Institute, spends half of his professional time treating patients with urologic...

issues in oncology

Experts Address Cancer Health Disparities in Facebook Live Session at AACR Meeting

Although it has long been known that certain cancer types disproportionately affect individuals from underserved and underrepresented populations, the sources of these disparities are still not entirely clear. In a “Facebook Live” session at the 2017 American Association for Cancer Research (AACR)...

issues in oncology
hematologic malignancies
solid tumors

Reports From JCO and JOP

Staying up-to-date with peer-reviewed oncology literature is a daunting task. To assist readers, The ASCO Post has summarized a number of studies recently published in the Journal of Oncology Practice (JOP) and the Journal of Clinical Oncology (JCO). Survival as Quality Metric in Cancer Care In a...

issues in oncology

Fleeing a Revolution, Becoming an Oncologist

Nicaragua, situated between Costa Rica and Honduras, is the poorest country in Central America. Following the U.S. occupation in 1912, the Somoza family began a brutal political dynasty that would end in 1979 during the bloody Nicaraguan Revolution.  Marcela G. del Carmen, MD, MPH, Chief Medical...

The Man in the Vest

It had been an uneventful Sunday morning, and I was writing my final note for the day, hopeful to make a stealth exit and perhaps join my family at church. But as I closed the chart and looked up, I saw Ruthie, my oncology fellow, approaching with a grim expression. “I just left the room of a...

hematologic malignancies

A Pioneer in Bloodless Transplant Discusses Advances in Blood Management

Bloodless stem cell transplantation, performed without the transfusion of allogeneic blood or blood products, has numerous clinical advantages, especially among populations of patients who prefer, for religious or other reasons, no blood methods of medical and surgical treatment. Patricia A. Ford, ...

lymphoma

FDA Approves CAR T-Cell Therapy for Adults With Certain Types of Large B-Cell Lymphoma

ON OCTOBER 18, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment....

Expert Point of View: Hope S. Rugo, MD

The Formal discussant of this presentation, Hope S. Rugo, MD, of the University of California, San Francisco, said, “Tailoring treatment to biology results in incremental improvements in outcome.” She continued: “This analysis gives us excellent data on the natural history of mostly hormone...

skin cancer

Melanoma Mutations: What You Need to Know

CLINICIANS ARE now well acquainted with BRAF mutations in advanced melanoma, but there is more to genomics in this disease than identifying BRAF and prescribing a BRAF inhibitor.  At the 2017 Debates and Didactics Conference, held at Sea Island, Georgia, Melinda L. Yushak, MD, MPH, of Emory...

solid tumors
breast cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

Expert Point of View: Nadia Harbeck, MD, PhD

Invited discussant Nadia Harbeck, MD, PhD, Head of the Breast Center of the University of Munich (LMU), Germany, said the UNICANCER-NeoPAL trial points toward the future of endocrine therapy in early breast cancer—using cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as a means of “enhancing” this ...

solid tumors
breast cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

hematologic malignancies
leukemia

Clinical Relevance of Minimal Residual Disease Monitoring Limited in Acute Myeloid Leukemia

Although a majority of major cancer centers may test for minimal residual disease (MRD), a recent survey conducted by researchers at Moffitt Cancer Center, Tampa, Florida, suggests most oncologists remain uncertain about what to do with the results. At the National Comprehensive Cancer Network®...

hematologic malignancies
lymphoma

New Options for the Management of Hodgkin Lymphoma

With the vast majority of patients cured with primary therapy, classical Hodgkin lymphoma is largely a success story. For the 10% to 20% of patients who either relapse or are refractory to front-line therapy, the disease can still be fatal. At the National Comprehensive Cancer Network® (NCCN®) 12th ...

lung cancer

Chronic Stress Hormones May Promote Resistance to EGFR Inhibitors in Patients With Lung Cancer

Elevated levels of chronic stress hormones, such as those produced by psychological distress, may promote resistance to drugs commonly used to treat lung cancer patients with EGFR mutations, according to new research from The University of Texas MD Anderson Cancer Center. Retrospective analysis of...

issues in oncology

Survival as Quality Metric in Cancer Care

In a National Cancer Data Base study reported in the Journal of Oncology Practice, Shulman et al found little difference in risk-adjusted cancer mortality rates among individual hospitals, suggesting survival may not be an ideal quality metric at the individual hospital level. However, survival was ...

gynecologic cancers

Study Finds HPV Screening May Be More Sensitive Than Pap Test for Detecting Cervical Cancer

The main goal of cervical screening programs is to detect and treat precancer before the cancer develops. Human papillomavirus (HPV) testing is more sensitive than cytology for detecting precancer. However, reports of rare HPV-negative, cytology-positive cancers are motivating the continued use of...

Paul Neiman, MD, PhD, Founding Member of Fred Hutch, Dies at 78

PAUL NEIMAN, MD, PhD, a founding member of Fred Hutchinson Cancer Research Center (Fred Hutch), transplant physician, and cancer biologist, died on October 11 of complications from pancreatic cancer. He was 78.  Dr. Neiman was also one of the founders and leaders of the Basic Sciences Division,...

Life With Death in the Room

It began, as so many do, with what a doctor often calls “a small spot,” a vague description that makes a potentially fatal disease sound like something that, with a slight bit of attention, can be ridded, like erasing a misplaced comma. In 2015, during a routine mammogram, doctors found one “small ...

A Revolutionary Technology Offers Hope and Ethical Concern

Aldous Huxley’s classic 1932 dystopian novel Brave New World pictures an eerie future where humans are genetically bred, altered to create worthy citizens. Welcome back to the future. First there was the astounding feat of sequencing the entire human genome; now, thanks to a revolutionary...

sarcoma
solid tumors

Conqueror in Action: Six-Time Survivor Brittany Sullivan Takes on Sarcoma

Alveolar soft part sarcoma (ASPS) is a cancer so rare that some oncologists have never heard of it. Brittany Sullivan, a 29-year-old anatomy teacher from Nashville, Tennessee, learned about it when she was 3 years old. She has been conquering it ever since. Since her childhood diagnosis, Ms....

solid tumors
breast cancer

Twisted Pink Joins Forces With the Conquer Cancer Foundation to Support Metastatic Breast Cancer Research

As one of the few organizations exclusively focused on funding research for metastatic breast cancer, Twisted Pink has a unique story to tell. Based in Louisville, Kentucky, the organization was founded in 2014 by breast cancer survivor Caroline Johnson. While Ms. Johnson fully recovered from her...

Emeritus Membership: What Does Retirement Mean to You?

In a 2013 survey, oncologists in the United States and Canada said they aim to retire at about age 64 or 65—but the majority transition into retirement in the few years after turning 65.1 When oncologists reach the point of retirement, the transition from ever-busy physician to retiree can be a...

leukemia

Immunotherapeutic Approaches for B-Cell Acute Lymphocytic Leukemia

New therapeutic agents for acute lymphocytic leukemia (ALL) have led to dramatic improvement in remission rates, but questions concerning the proper sequencing and combination of these agents remain. At the National Comprehensive Cancer Network® (NCCN®) 13th Annual Congress: Hematologic...

gastrointestinal cancer

Quick Takes on Studies in Noncolorectal Gastrointestinal Cancers

In this roundup, The ASCO Post offers a glance at key findings from studies in noncolorectal gastrointestinal malignancies presented at the European Society for Medical Oncology (ESMO) 2017 Congress from investigators around the world. Docetaxel-Based Triplet in Gastric Cancer The superiority of...

lung cancer

EXPERT POINT OF VIEW: Kemp Kernstine, MD, PhD

The study’s invited discussant Kemp Kernstine, MD, PhD, the Robert Tucker Hayes Foundation Distinguished Chair in Cardiothoracic Surgery at The University of Texas Southwestern Medical Center, Dallas, welcomed the findings, but expressed some concerns about the study. To begin, of a database of...

cns cancers

AACR-NCI-EORTC: Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

More than a quarter of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 (vocimagene amiretrorepvec) combined with Toca FC (an extended-release formulation of fluorocytosine, a prodrug of fluorouracil [5-FU]) were alive more than 3 years after...

Documentary Film Takes a Walk on the Wild Side With Oncology Pioneers

Oncology luminaries. Thought leaders. The soul of chemotherapy. These are just a few of the phrases used to describe Emil Frei, MD, FASCO, Emil J Freireich, MD, FASCO, James F. Holland, MD, FASCO, Georges Mathé, MD, and their historic contributions to the world of oncology. Inspired by these...

skin cancer

Expert Point of View: Alexander Eggermont, MD, PhD

BASED ON THE RESULTS of COMBI-AD1 and CheckMate 238,2 invited discussant Alexander Eggermont, MD, PhD, Professor of Oncology at Gustave Roussy in Paris, commented: “It’s a good day for melanoma!”  In COMBI-AD, treatment with the combination of dabrafenib (Tafinlar) and trametinib (Mekinist)...

hematologic malignancies

Early Love of Science and Famous Mentor Paved the Way for Gwen L. Nichols, MD, in Hematologic Cancer

Nationally regarded leukemia and lymphoma specialist Gwen L. Nichols, MD, was born in the Bronx, New York, and when she became of school age, her parents moved to the upstate suburb of Chappaqua, where she grew up. Asked if there were any physicians in her family who might have influenced her...

lymphoma

FDA Approves CAR T-Cell Therapy to Treat Adults With Certain Types of Large B-Cell Lymphoma

On October 18, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment....

lung cancer

IASLC 2017: Lorlatinib in ALK-Positive and ROS1-Positive Advanced Non–Small Cell Lung Cancer

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Pfizer announced full results from the phase II clinical trial of the investigational, next-generation tyrosine kinase inhibitor lorlatinib. The agent exhibited clinically...

lung cancer

Results From the Phase III JUNIPER Trial Evaluating Abemaciclib in KRAS-Mutated, Advanced NSCLC

On October 10, Eli Lilly and Company announced that its phase III JUNIPER study evaluating abemaciclib (Verzenio), a cyclin-dependent kinase (CDK) 4 and CDK6 inhibitor, as monotherapy in KRAS-mutated, advanced non–small lung cancer (NSCLC) did not meet its primary endpoint of overall...

gastroesophageal cancer

Adjuvant Chemotherapy vs Observation After Preoperative Chemoradiotherapy and Resection in Gastroesophageal Cancer

In a propensity score–matched analysis reported in JAMA Oncology, Mokdad et al found that adjuvant chemotherapy had a survival benefit vs observation after preoperative chemoradiotherapy and resection in patients with locally advanced gastroesophageal cancer. Study Details The study...

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