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issues in oncology
health-care policy
legislation
cost of care

Will the Trump Administration’s Plan to Reduce Cancer Drug Prices Work?

High drug prices are the number one health-care concern of many Americans. The average price of a cancer drug rose from less than $10,000/yr before 2000 to more than $170,000/yr in 2017.1-3 Between 1995 and 2013, the launch price of cancer drugs increased by 10% to 12% every year, and the average...

leukemia

MURANO Trial Follow-up: MRD and Prognosis With Fixed Duration of Venetoclax/Rituximab in Relapsed or Refractory CLL

As reported in the Journal of Clinical Oncology by Kater et al, high undetectable minimal residual disease (MRD) rates persisted after the end of venetoclax (Venclexta)/rituximab (Rituxan) treatment in the phase III MURANO trial in relapsed or refractory chronic lymphocytic leukemia (CLL), and were ...

lymphoma
immunotherapy

ECHELON-2: Brentuximab Vedotin Plus Chemotherapy in CD30-Positive Peripheral T-Cell Lymphoma

As reported by Horwitz et al in The Lancet, the phase III ECHELON-2 trial showed that brentuximab vedotin (Adcetris) plus cyclophosphamide, doxorubicin, and prednisone (CHP) improved progression-free and overall survival vs cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in...

lymphoma

Expert Point of View: Laurie H. Sehn, MD

LAURIE H. SEHN, MD, Chair, Lymphoma Tumour Group, BC Cancer Agency, Vancouver, British Columbia, Canada, said these results are not unexpected and support de-escalation in selected patients. “The FLYER trial evaluates treatment with four cycles compared with six cycles of cyclophosphamide,...

lymphoma

De-escalation of Chemotherapy in Favorable-Risk Diffuse Large B-Cell Lymphoma

THE REGIMEN of four cycles of rituximab (Rituxan)/cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) plus two cycles of rituximab was noninferior to that of six cycles of R-CHOP in younger patients with favorable-risk diffuse large B-cell lymphoma (DLBCL), according to the results of...

lung cancer
immunotherapy

FDA Approves Atezolizumab in Combination With Bevacizumab and Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC

On December 6, 2018, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of patients with metastatic, nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or...

hematologic malignancies
leukemia

A Battle With Leukemia: Part Memoir, Part Oncology History

BOOKMARK Title: Cancer Crossings: A Brother, His Doctors, and the Quest for a Cure to Childhood LeukemiaAuthor: Tim WendelPublisher: ILR PressPublication date: April 2018Price: $24.95, hardcover, 256 pages Tim Wendel is a journalist and author of several noted books, mostly concerning sports. In...

UPMC Hillman Cancer Center Scientists Receive Grant for Breast Cancer Research

Four breast cancer researchers from the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center have received nearly $1 million from the Breast Cancer Research Foundation (BCRF) to further breast cancer research from the most basic biology of a cancer cell to developing innovative new...

leukemia
immunotherapy

ASH 2018: Hematopoietic Stem Cell Transplant After CD19 CAR T-Cell Therapy in ALL

In a new study presented by Summers et al at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 967), patients with acute lymphoblastic leukemia (ALL) who received a first stem cell transplant after CD19 chimeric antigen receptor (CAR) T-cell therapy were less...

lymphoma

ASH 2018: Four vs Six Cycles of Chemotherapy in Diffuse Large B-Cell Lymphoma

A new study suggests that it may be safet to reduce the standard course of treatment for younger patients with low-risk diffuse large B-cell lymphoma (DLBCL) by two cycles of chemotherapy. The trial, which tracked patients for a median of more than 5 years and up to 11 years, showed 4 cycles of...

kidney cancer

Adding Genomic Factors to MSKCC Risk Model in Metastatic Renal Cell Carcinoma

In a study reported in The Lancet Oncology, Voss et al found that adding the mutation status of prognostic genes to the Memorial Sloan Kettering Cancer Center (MSKCC) risk model improved the prognostic performance of the model in patients with advanced renal cell carcinoma. The study involved...

solid tumors

EORTC-NCI-AACR: Investigational Anti-HER2 Therapy in HER2-Expressing Solid Tumors

An antibody that binds simultaneously to two distinct regions of the HER2 receptor to block the growth of cancer cells has shown antitumor activity in a number of cancers, including those of the esophagus, stomach, and bowel. Updated results from a phase I clinical trial of the treatment, called...

leukemia

A Single CAR T Cell Cured My Chronic Lymphocytic Leukemia

The combination of symptoms I began experiencing in the spring of 2007, including night sweats so severe they woke me from a sound sleep and midline chest wall swelling so extreme I needed a larger shirt size, drove me to seek immediate medical attention. A series of imaging and blood tests...

Six Hospital Systems Launch Research Center on Symptom Management

SIX HOSPITAL systems across the country are launching a new research collaboration to improve the reporting and management of cancer treatment–related symptoms. The initiative, known as the SIMPRO Research Center, will integrate the use of patient-reported outcomes into the routine practice of...

issues in oncology
immunotherapy

The Abscopal Effect: A Reemerging Field of Interest

For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements...

Thank You From Conquer Cancer

When you give to ASCO’s Conquer Cancer Foundation, your donation provides grants to researchers around the world. Research fuels the breakthroughs in cancer prevention and treatment needed for every cancer, every patient, everywhere. “Year after year, we meet patients who credit their successful...

leukemia
immunotherapy

Azacitidine Plus Nivolumab in Relapsed or Refractory AML

A combination of the chemotherapy drug azacitidine with the immune checkpoint inhibitor nivolumab (Opdivo) demonstrated an encouraging response rate and overall survival in patients with relapsed or refractory acute myeloid leukemia (AML), according to findings from a phase II study published...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...

First Oncology Practice in Romania Certified by U.S. Quality Cancer Care Program

THE NUMBER of international practices certified in delivering high-quality cancer care based on rigorous standards established by ASCO is increasing. The Medisprof Cancer Center in Romania joins six other practices in Brazil, Greece, and Spain in achieving ASCO’s Quality Oncology Practice...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

bladder cancer
immunotherapy

Pembrolizumab Shows Antitumor Activity in Non–Muscle Invasive Bladder Cancer

THE ANTI–PROGRAMMED cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab (Keytruda) was found to have antitumor activity in patients with high-risk non–muscle invasive bladder cancer who were nonresponsive to bacillus Calmette-Guérin (BCG), according to the preliminary results of the ...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

lymphoma

Final Overall Survival Results for First-Line VR-CAP vs R-CHOP in Transplantation-Ineligible Mantle Cell Lymphoma

In an analysis reported in The Lancet Oncology by Robak et al, bortezomib, rituximab [Rituxan], cyclophosphamide, doxorubicin, and prednisone (VR-CAP) significantly prolonged overall survival vs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in a phase III trial ...

kidney cancer

2018 ASTRO: IROCK: Stereotactic Ablative Radiotherapy for RCC in Patients With One Kidney

Treatment of renal cell carcinoma with stereotactic radiation therapy is as safe and effective for patients with one kidney as it is for those with two, according to an analysis of an international data set presented by Correa et al at the 60th Annual Meeting of the American Society for...

head and neck cancer

2018 ASTRO: Liquid Biopsy in HPV-Associated Oral Cancer Surveillance

A highly sensitive blood test that detects minute traces of cancer-specific DNA has been shown to accurately determine whether patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) are free from cancer following radiation therapy. Findings were presented by...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hepatobiliary cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

gynecologic cancers

Adjuvant Chemotherapy in High-Grade Uterine Leiomyosarcoma

As reported in the Journal of Clinical Oncology by Hensley et al, a phase III NRG Oncology/Gynecologic Oncology Group study assessing adjuvant chemotherapy vs observation in disease-free patients with uterus-confined high-grade leiomyosarcoma was stopped due to accrual futility; available data...

breast cancer

Study Finds Deep Learning Can Distinguish Recalled-Benign Mammogram Images From Malignant and Negative Cases

Although digital mammography is effective in detecting early-stage breast cancer and in reducing mortality, high recall rates after a screening mammogram often result in unnecessary medical procedures, including breast biopsies, medical costs, and psychological stress for patients.   A...

issues in oncology

Report Outlines Cancer Risk Among Hispanics/Latinos in the United States

The cancer burden in Puerto Rico, a U.S. territory with a 99% Hispanic population, is substantially different from that of Hispanics in the continental United States, according to Cancer Statistics for Hispanics/Latinos, 2018. The report, published every 3 years, found that men in Puerto Rico...

breast cancer

Living a Purposeful Life Is My Revenge on Cancer

There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

skin cancer

FDA Approves Cemiplimab-rwlc for Metastatic Cutaneous Squamous Cell Carcinoma

On September 28, the U.S. Food and Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo) injection for intravenous use for the treatment of patients with metastatic cutaneous squamous cell carcinoma (SCC) or locally advanced cutaneous SCC who are not candidates for curative surgery or...

lung cancer

WCLC 2018: Poziotinib in Stage IV NSCLC With Genetic Mutations

Findings presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) showed poziotinib demonstrates clinical activity among patients with stage IV NSCLC with genetic mutations that have previously not responded to treatment....

lung cancer

WCLC 2018: Nintedanib Plus Pemetrexed/Cisplatin Does Not Improve PFS or OS in Malignant Pleural Mesothelioma of Epithelioid Subtype

Findings from a recent study demonstrate that the triple angiokinase inhibitor nintedanib combined with standard-of-care pemetrexed (Alimta)/cisplatin does not impact progression-free survival (PFS) and overall survival (OS) for patients with unresectable malignant pleural mesothelioma with...

David J. Sugarbaker, MD, Pioneer in Thoracic Surgery, Mesothelioma, Dies at 65

DAVID J. SUGARBAKER, MD, was an internationally recognized thoracic surgeon who specialized in the treatment of mesothelioma and complex thoracic cancers. To be recognized as first in a medical finding or procedure is a rare honor; Dr. Sugarbaker received that honor twice, being the first to...

colorectal cancer

Triplet Combination for Advanced Anal Squamous Cell Carcinoma

In a French phase II trial reported in The Lancet Oncology, Stefano Kim, MD, of the Department of Oncology, University Hospital of Besancon, and colleagues found that treatment with docetaxel, cisplatin, and fluorouracil (DCF) was active in patients with metastatic or unresectable locally...

immunotherapy

A Journey Through the Immune System

Although the basic concept of using the body’s immune defense mechanisms to fight cancer has been around for centuries, the idea of using immunotherapy in cancer, in general, returned to prominence when Dr. Thomas Burnet first proposed the theory of cancer immunosurveillance in 1957. Despite...

geriatric oncology

Educating Nurse Practitioners on the Care of Older Patients With Cancer in a Comprehensive Cancer Center

To expose future practitioners to the special challenges of treating cancer in older patients, the Geriatrics Service at Memorial Sloan Kettering Cancer Center (MSK) has developed a clinical education model for nurse practitioner students. Why Geriatric Oncology? GIVEN THE aging population, my...

symptom management

ASCO/IDSA Clinical Practice Guideline Update: Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression

As reported in the Journal of Clinical Oncology by Randy A. Taplitz, MD, of UC San Diego Health, and colleagues, ASCO and the Infectious Diseases Society of America (IDSA) have updated their joint guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with...

2019 Pershing Square Sohn Cancer Research Prize Is Opening for Applications on October 1, 2018

THE PERSHING Square Sohn Cancer Research Alliance will open for applications for its 2019 Pershing Square Sohn Prize for Young Investigators in Cancer Research on October 1, 2018. At least six New York City area–based scientists will each be awarded $200,000 per year for up to 3 years. Applicants...

lymphoma
geriatric oncology

Challenges of Managing Older Patients With Diffuse Large B-Cell Lymphoma

As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...

hematologic malignancies

FDA Approves First Nonchemotherapy Combination Regimen for Patients With Waldenström’s Macroglobulinemia

ON AUGUST 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) for patients with Waldenström’s macroglobulinemia. The recent approval expands the label for ibrutinib in Waldenström’s macroglobulinemia beyond its current...

breast cancer

Proteomics May Be Used to Predict Treatment Outcomes in Triple-Negative Breast Cancer

In triple-negative breast cancer, researchers have so far been unable to identify markers that can classify patients by prognosis or probability of responding to different treatments. In a study published by Zagorac et al in Nature Communications, researchers from the Spanish National Cancer...

solid tumors

PDL1 Amplification in Solid Tumors

In a study reported in JAMA Oncology, Aaron M. Goodman, MD, of the University of California, San Diego Moores Center for Personalized Cancer Therapy, and colleagues found amplification of PDL1 genes in 0.7% of solid tumors, including more than 100 tumor types. Response to checkpoint inhibition was ...

issues in oncology
global cancer care

Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Barbados

GUEST EDITOR The ASCO Post is pleased to continue this special feature on the worldwide cancer burden. Each installment focuses on a country from one of the six regions of the world, as defined by the World Health Organization (ie, Africa, the Americas, South-East Asia, Europe, Eastern...

Improving the Lives of Patients With Cancer Is Richard L. Schilsky’s Lifelong Mission

In 2009, as Richard L. Schilsky, MD, FACP, FSCT, FASCO, was preparing his Presidential Address for that year’s ASCO Annual Meeting, he came across his 6th grade essay titled “My Ambition,” which foretold with eerie specificity the career path he would follow over the next 6 decades. In the paper,...

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