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head and neck cancer

Durvalumab With or Without Tremelimumab in Recurrent or Metastatic HNSCC With Low/No PD-L1 Expression

In a randomized phase II trial reported in JAMA Oncology, Siu et al found that the combination of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) plus the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab and durvalumab alone showed evidence ...

solid tumors

Transcription Factors TP63 and SOX2 in Squamous Cell Carcinoma Progression

Squamous cell carcinomas (SCCs) are malignancies arising from squamous epithelium of various organs, such as esophagus, head and neck, lung, and skin.  Previous studies demonstrated that two master transcription factors, TP63 and SOX2, effect genomic activation in SCCs. Now, researchers from...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology
cost of care

Tackling Financial Toxicity: One Institution’s Roadmap Forward

  ALTHOUGH FINANCIAL toxicity has become an important issue in the oncology community, evidence suggests the subject is rarely addressed by oncologists, exacerbating its grave effects on patients with cancer and their families.1 “But I don’t think it’s because health-care providers don’t want to...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

breast cancer
immunotherapy

Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer

IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...

solid tumors

Incidental Germline Mutations in Patients With Advanced Solid Tumors Identified by Cell-Free Circulating Tumor DNA Testing

In a study reported in the Journal of Clinical Oncology, Slavin et al determined the prevalence of a set of germline cancer predisposition gene mutations incidentally identified by cell-free circulating tumor DNA (cfDNA) testing in patients with advanced solid tumors. Study Details The study...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

Living a Full Life After a Diagnosis of Cancer

BOOKMARK Title: Here We Grow: Mindfulness Through Cancer and BeyondAuthor: Paige DavisPublisher: She Writes PressDate: May 2018Price: $22.95, paperback, 154 pages Since the publication of Dr. Paul Kalanithi’s best-selling book, When Breath Becomes Air, about his diagnosis of cancer and untimely...

Never a Doubt About a Career in Medicine for Anne S. Tsao, MD

There was no epiphany or family influences, as long as she can remember; Anne S. Tsao, MD, always wanted to be a doctor or, because of her love for caring for sick animals, a veterinarian. Dr. Tsao was born in Fountain Creek, Pennsylvania, but her parents moved to a suburb just outside of Chicago...

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...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

Connie J. Eaves, PhD, FRS, to Give Honorary Lecture at 2018 ASH Annual Meeting

The American Society of Hematology (ASH) will honor Connie J. Eaves, PhD, FRS, of BC Cancer at the University of British Columbia, with the 2018 E. Donnall Thomas Lecture and Prize for her contributions to the field of hematopoiesis and stem cell research. Dr. Eaves will present her lecture,...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

issues in oncology
health-care policy

Health-Policy Forum Focuses on New Care-Delivery Paradigms

What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...

Humbled by Challenges, Renowned Hematologist Kanti R. Rai, MD, Recalls a Rich Career

For this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, interviewed Kanti R. Rai, MD, Professor of Medicine at the Karches Center for Oncology Research, Feinstein Institute for Medical Research, Manhasset; Professor of Medicine at Zucker School of Medicine at...

I’m Not Dying of Cancer: I’m Living With Cancer

I’m a psychiatrist, so I don’t say this lightly: receiving a diagnosis of stage IV gastric adenocarcinoma made me insane. I had remembered the horrible deaths due to abdominal cancer I had seen during my medical training and was terrified that would be my fate as well. I knew from looking at the...

Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

On the Frontier of Breast Cancer Research With Joyce A. O’Shaughnessy, MD

Nationally regarded breast cancer researcher and clinician Joyce A. O’Shaughnessy, MD, was born in upstate New York, just outside of Albany, where she attended grade school before her family moved to Beverly, Massachusetts, a suburban town 26 miles from Boston, where her family’s roots were....

solid tumors
head and neck cancer

The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer

When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...

issues in oncology

Quality Improvement: Worth the Effort but Not Always Easy to Execute

According to Kaveh Shojania, MD, the keynote speaker at the 2018 ASCO Quality Care Symposium, dedicated quality improvement work can help repair a fragmented health-care delivery system, but it’s challenging, and there are multiple things that can go wrong during the process.1 “I’ve developed this ...

immunotherapy

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how a...

issues in oncology
genomics/genetics

Next-Generation Sequencing: New Technology That Requires Further Thought

Next-generation sequencing is used with increasing frequency to provide essential information about a patient’s diagnosis and treatment. In recent months, the U.S. Food and Drug Administration (FDA) has approved several new next-generation sequencing diagnostic tools, and the Centers for Medicare...

breast cancer
immunotherapy

ESMO 2018: IMpassion 130: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer

A combination of immunotherapy and chemotherapy improves survival in some patients with metastatic triple-negative breast cancer, according to late-breaking results from the IMpassion130 trial reported by Schmid et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...

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...

breast cancer

ESMO 2018: Patients With Breast Cancer Use Twitter as a Nonmedical Forum to Share Experiences

Twitter is a place where many patients with cancer go to share and discuss their experiences of the disease, according to a recent exploratory study to be presented by Sánchez-Bayona et al at the European Society for Medical Oncology (ESMO) 2018 Congress (360P_PR). The...

issues in oncology

ESMO 2018: Precision Cancer Care Moves to Community Setting

Nearly 1 in 4 patients with advanced cancer treated at a community practice cancer network in the United States received innovative drugs matched to DNA mutations in their tumors. These results, to be reported by Alvarez et al at the European Society for Medical Oncology (ESMO) 2018 Congress...

breast cancer
issues in oncology
survivorship

Cognitive Outcomes Among Older Survivors of Breast Cancer

In a study (Thinking and Living with Cancer) reported in the Journal of Clinical Oncology, Mandelblatt et al found that poorer cognitive function in older survivors of breast cancer was associated with chemotherapy, hormone therapy, and ApoE genotype. The ApoE ε4 allele has been associated...

A Pathologic Fascination With Humanity

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Proton Therapy Leader, James D. Cox, MD, Dies at 80

THE ACCLAIMED radiation oncologist James D. Cox, MD, led MD Anderson’s Proton Therapy Center, an international center of excellence for proton therapy, research, and education, distinguished as the world’s first proton therapy facility located within a comprehensive cancer center. At the 2017...

Johns Hopkins Radiation Oncology Pioneer, Moody Wharam, Jr, MD, Dies at 77

MOODY WHARAM, JR, MD, Professor Emeritus of Radiation Oncology and Molecular Radiation Sciences and former Willard and Lillian Hackerman Professor of Radiation Oncology at the Johns Hopkins Kimmel Cancer Center, died on August 10 at the age of 77. Dr. Wharam specialized in the treatment of...

On Aging and the Wellness Industry

Only a few centuries ago, the major source of moral and scientific authority in Western culture was religion, which requires trusting one of numerous supernatural deities. However, the presumption that medicine is based on evidence-based and peer-reviewed science is what gives it authority in...

breast cancer

An Early Love of Literature Gives Way to a Career in Breast Cancer Research for Jennifer K. Litton, MD

Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was...

immunotherapy

James Allison, PhD, and Tasuku Honjo, MD, PhD, Win 2018 Nobel Prize in Physiology or Medicine

JAMES ALLISON, PHD, Chair of Immunology and Executive Director of the Immunotherapy Platform at The University of Texas MD Anderson Cancer Center, and Tasuku Honjo, MD, PhD, Distinguished Professor at the Kyoto University Institute for Advanced Study and Professor of Immunology and Genomic Medicine ...

solid tumors
issues in oncology

New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer

Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the...

issues in oncology
symptom management

Small Study Shows Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Taur...

colorectal cancer
issues in oncology

Sex-Linked Differences in Cancer May Identify Specific Genetic Drivers, Predict Responses to Treatment

Analysis of male- and female-derived tumor samples revealed differences in prognostic biomarkers, genes that drive cancer, and in regulation of key pathways that may predict responses to treatment, according to results published in two studies in Cancer Research, one by Li et al and the other...

Conquer Cancer Podcast Series Goes Unscripted With Doctors, Patients, and Caregivers

How do patients really feel when they are in your care? What does it feel like to cure a cancer? How are the children of oncologists affected when grief is a parent’s occupational hazard? These are the personal topics explored in the candid and inspirational mini-podcast series, Your Stories:...

lung cancer
pain management

Study Shows Invasive Lung Cancer Surgery Can Lead to Long-Term Opioid Use

Patients treated with more invasive surgical techniques for early-stage non–small cell lung cancer (NSCLC) are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery ...

gastrointestinal cancer

Neuroendocrine Tumors: New Data, New Options

Because neuroendocrine tumors are not one disease but a continuum of diseases, ranging from well-differentiated tumors to poorly differentiated and small cell tumors, treatment approaches can vary greatly. At the 2018 Debates and Didactics in Hematology and Oncology conference, held on Sea Island,...

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

James Allison, PhD, and Tasuku Honjo, MD, PhD, Win 2018 Nobel Prize in Physiology or Medicine

James Allison, PhD, Chair of Immunology and Executive Director of the Immunotherapy Platform at The University of Texas MD Anderson Cancer Center, and Tasuku Honjo, MD, PhD, Distinguished Professor at the Kyoto University Institute for Advanced Study and Professor of Immunology...

lung cancer

WCLC 2018: NELSON Study: CT Screening for Early Lung Cancer Reduces Lung Cancer Mortality

Findings from the NELSON study demonstrate that the use of computed tomography (CT) screening among asymptomatic men at high risk for lung cancer led to a 26% (95% confidence interval [CI] = 9%–41%) reduction in lung cancer deaths at 10 years of study follow-up (at 86% compliance). In the...

breast cancer
genomics/genetics

Expect Questions About Genetic Testing for Breast Cancer

A STUDY finding that pathogenic variants in 5 genes are associated with a high risk of triple-negative breast cancer and a 20% lifetime risk for overall breast cancer1 may increase interest in genetic testing. “This is the first study to establish which genes are associated with high lifetime risks ...

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...

Brave Journey Home

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

issues in oncology
cost of care

Understanding the Different Perspectives on Cost and Value in Cancer Care

The estimated cost of cancer care in the United States was $125 billion in 2010 and is expected to rise to $175 billion by 2020.1 In an effort to reign in spiraling costs and deliver better care, the term “value” has become part of the new oncology lexicon, as providers, patients, and payers seek...

breast cancer
issues in oncology
cost of care

2018 Quality Care: Nationwide Survey Reveals Patients With Metastatic Breast Cancer Face Major Financial Stress Due to Treatment Costs

A new nationwide analysis of more than 1,000 people living with metastatic breast cancer from 41 states reveals significant cancer-related financial burden known as financial toxicity, particularly for uninsured patients. The study will be presented by Wheeler et al at the upcoming 2018 ASCO...

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