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issues in oncology

Inflammation, DNA Damage, and Cancer

The link between inflammation and cancer is a field of growing interest in the oncology community. Biologists have theorized that simultaneous DNA damage and cell division during inflammation could lead to cancer. To shed light on this important issue, The ASCO Post recently spoke with Jennifer...

Johns Hopkins Medicine Appoints Allen Kachalia, MD, JD, to Leadership Positions

Allen Kachalia, MD, JD, will be appointed Director of the Armstrong Institute for Patient Safety and Quality and Senior Vice President of Patient Safety and Quality for Johns Hopkins Medicine, starting December 1. During his nearly 20-year career in medicine, Dr. Kachalia has served in a variety...

hematologic malignancies
lymphoma
leukemia

Leukemia & Lymphoma Society Receives Funding for New Grants

The Leukemia & Lymphoma Society recently announced a $1,175,000 commitment by the Schwartz Ward Family Foundation of Chicago to support two research initiatives. These funds will support two grants in the society’s Career Development Program: Christiane Querfeld, MD, PhD, of City of Hope, is...

solid tumors
hepatobiliary cancer

Global Liver Institute Supports More Frequent Liver Cancer Screening

When detected early, liver cancer is highly treatable and, in many cases, curable, yet the number of new cases of liver cancer in the United States has increased by 43% in the past 16 years, whereas the incidence of other cancers is on the decline. This past October, during Liver Cancer Awareness...

lung cancer

Dacomitinib for Metastatic EGFR-Mutant NSCLC

On September 27, 2018, dacomitinib (Vizimpro) received approval for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations, as detected by a test approved by the...

lung cancer

FDA Approves Lorlatinib for Second- or Third-Line Treatment of ALK-Positive Metastatic NSCLC

On November 2, 2018, the U.S. Food and Drug Administration granted accelerated approval to lorlatinib (Lorbrena) for patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK ...

hematologic malignancies

Ibrutinib Plus Rituximab in Adult Patients With Waldenström’s Macroglobulinemia

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On August 27, 2018, ibrutinib (Imbruvica) was approved...

prostate cancer
issues in oncology

Undertreatment of High-Risk Prostate Cancer in Latino Men

New research by Lichtensztajn et al in JNCCN—Journal of the National Comprehensive Cancer Network examined disparities in care for Latino men with prostate cancer. A team of researchers from UCSF Helen Diller Family Comprehensive Cancer Center, Stanford Cancer Institute, and...

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...

gynecologic cancers

Neoadjuvant Chemotherapy vs Upfront Debulking Surgery in Advanced Tubo-Ovarian Cancer

As reported in The Lancet Oncology by Vergote et al, a pooled analysis of individual patient data in long-term follow-ups of the phase III EORTC 55971 and CHORUS trials indicated that overall survival is similar with neoadjuvant therapy vs upfront debulking surgery in advanced tubo-ovarian cancer....

colorectal cancer

Multimodality Therapy and Lateral Local Recurrence in Rectal Cancer

In a study reported in the Journal of Clinical Oncology, Ogura et al found that lateral lymph node dissection (LLND) reduced the risk of lateral local recurrence in patients with lateral nodes ≥ 7 mm undergoing neoadjuvant chemoradiation or radiation and total mesorectal excision in clinical...

Steven A. Rosenberg, MD, PhD, Works to Unmask Cancer’s Achilles Heel

Steven A. Rosenberg, MD, PhD, knew from the start of his medical career that if treatments for cancer were to become curative, research in new therapies would have to move away from the mainstay one-size-fits-all approach of systemic chemotherapy to an innovative, personalized strategy that...

breast cancer

Quality of Life With Postmastectomy Radiotherapy vs No Radiotherapy in Intermediate-Risk Breast Cancer

In a 2-year follow-up of the phase III SUPREMO trial reported in The Lancet Oncology, Galina Velikova, PhD, of the Leeds Cancer Centre, St. James’s University Hospital, United Kingdom, and colleagues found worse chest wall symptoms in women with intermediate-risk breast cancer who did vs did not...

prostate cancer

ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy

Three prominent medical organizations have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Developed by a panel of experts from the American Society for Radiation Oncology (ASTRO), ASCO, and the American...

Atlantic Health System Announces Collaboration to Further Patient Access to Innovative Cancer Therapies

The Atlantic Health System, an integrated health-care delivery system, recently announced a partnership with the Translational Genomics Research Institute, an affiliate of City of Hope, and Origin Commercial Ventures to create a new platform to deliver economically viable immunotherapies and other...

issues in oncology

Nosayaba Osazuwa-Peters, MPH, PhD, on Suicide Among Male Patients With Cancer: Study Findings

Nosayaba Osazuwa-Peters, MPH, PhD, of St. Louis University, discusses study findings on married cancer survivors with advanced stage disease who were less likely to die by suicide, highlighting the value of supportive care in cancer survivorship (Abstract 181).

issues in oncology
global cancer care

Building Improved and Sustainable Health-Care Systems Through Telemedicine

Telemedicine—the remote diagnosis and treatment of patients via telecommunications technology—has changed the way oncology care is delivered in rural parts of the world. Patients in rural areas are now able to connect remotely with their physicians without having to deal with the time, expense, and ...

Heidi Nelson, MD, FACS, Named Medical Director of ACS Cancer Programs

The American College of Surgeons (ACS) announced that Heidi Nelson, MD, FACS, a colorectal surgeon at the Mayo Clinic in Rochester, Minnesota, will be joining the ACS Division of Research and Optimal Patient Care (DROPC) as Medical Director of Cancer Programs. Dr. Nelson comes to the ACS from her...

issues in oncology
immunotherapy
symptom management

Allison S. Betof Warner, MD, PhD, on Managing Immune-Related Adverse Events: Incorporating Guidelines

Allison S. Betof Warner, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses the rationale for immunotherapy and combination treatments, identifying the agents that lead to toxicities, and ways to manage them.

issues in oncology
pain management

Charles von Gunten, MD, PhD, on Protecting Opioid Access for Patients in Need

Charles von Gunten, MD, PhD, of OhioHealth, discusses the critical need for opioids to manage cancer pain as well as the myth of addiction, which may impede best care.

supportive care
symptom management

Eric Roeland, MD, on Preventing Chemotherapy-Induced Vomiting

Eric Roeland, MD, of Massachusetts General Hospital, discusses the wide variation among physicians in preventing vomiting from highly emetogenic chemotherapy (Abstract 74).

Charles Gawad, MD, PhD, Receives NIH Director’s New Innovator Award

Charles Gawad, MD, PhD, an assistant member in the Departments of Oncology and Computational Biology at St. Jude Children’s Research Hospital, has been selected by the National Institutes of Health (NIH) to receive a Director’s New Innovator Award. Established in 2007, this award supports...

issues in oncology

Modern Clinical Trials: Engaging Stakeholders at the Front Lines of Care

Randomized clinical trials have been providing high-quality evidence for decades, but there are limitations to the traditional design. At the 2018 ASCO Quality Care Symposium, George J. Chang, MD, MS, FACS, FASCRS, discussed the need to modernize clinical trials, so they continue to provide...

geriatric oncology
palliative care

Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care

Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).

Expert Point of View: Sandro Pignata, MD

The study’s invited discussant, Sandro Pignata, MD, of the Istituto Nazionale Tumori di Napoli in Italy, called the data from AGO OVAR 2.21 “very strong.” He added: “We now have robust evidence from a trial of more than 600 patients, in which previous bevacizumab (Avastin) was allowed, that...

supportive care
pain management

Mihir M. Kamdar, MD, on Managing Cancer-Related Pain With Artificial Intelligence

Mihir M. Kamdar, MD, of Massachusetts General Hospital, discusses study findings on a smartphone app called ePAL, which significantly reduces pain and pain-related hospital admissions by combining patient-reported outcome data and artificial intelligence via a telemedicine platform (Abstract 76).

gynecologic cancers

Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer

For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...

issues in oncology
palliative care

Mary E. Johnson on Holding Vigil With Dying Loved Ones

Mary E. Johnson, author of Stay With Me Awhile, discusses her play, a compilation of vigil stories from across cultures and religions, and the profound impact the performances have had on audience members.

issues in oncology
immunotherapy

Betty R. Ferrell, PhD, on Quality of Life in the Era of Immunotherapy

Betty R. Ferrell, PhD, of City of Hope, discusses the many advances in immunotherapy and the drugs’ effect on patients’ quality of life, including psychological well-being.

immunotherapy
symptom management

Elizabeth Jane Cathcart-Rake, MD, on Immunotherapy-Related Toxicities: More Common Than Originally Reported?

Elizabeth Jane Cathcart-Rake, MD, of the Mayo Clinic, discusses the frequency of side effects from immunotherapy, the need to closely monitor those receiving this treatment, and the role of clinicians in educating their patients on toxicities (Abstract 184).

Expert Point of View: Caroline Robert, MD, PhD

The paper’s invited discussant, Caroline Robert, MD, PhD, of the Institut de Cancérologie Gustave Roussy, Villejuif, France, said OpACIN-neo attained its goal of reducing toxicity and maintaining efficacy. The regimen of two courses of ipilimumab (Yervoy) at 1 mg/kg plus nivolumab (Opdivo) at 3...

skin cancer
immunotherapy

Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma

In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...

Expert Point of View: Daniel Heinrich, MD, and Silke Gillessen, MD

Formal discussant of the ERA 223 trial, Daniel Heinrich, MD, of Akershus University Hospital, Lørenskog, Norway, reminded listeners at the European Society for Medical Oncology (ESMO) 2018 Congress that radium-223 was developed in Norway. “When the ALSYMPCA results came out, we were celebrating....

prostate cancer

Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer

The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...

Expert Point of View: Viktor Grünwald, MD, PhD

Formal discussant Viktor Grünwald, MD, PhD, of the Hannover Medical School, Germany, agreed that the results of JAVELIN Renal 101 were impressive, but he was more cautious about accepting avelumab (Bavencio)/axitinib (Inlyta) as a new standard of care without longer follow-up and quality-of-life...

kidney cancer
immunotherapy

Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma

In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...

cost of care

Mary K. Buss, MD, MPH, and Candice A. Johnstone, MD, MPH, on Financial Toxicity During Treatment and Beyond

Mary K. Buss, MD, MPH, of Beth Israel Deaconess Medical Center, and Candice A. Johnstone, MD, MPH, of the Medical College of Wisconsin, discuss a session they co-chaired on the perspective of stakeholders on the cost of cancer care, what drives patients’ preferences when faced with mounting medical ...

Expert Point of View: Amanda Psyrri, MD, PhD

Formal discussant of this trial, Amanda Psyrri, MD, PhD, of the University of Athens Medical School, Attikon Hospital, Athens, Greece, commented on these results, suggesting they would affect clinical practice “tomorrow.” “Cisplatin/radiotherapy remains the standard of care for low-risk human...

head and neck cancer

Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer

In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...

palliative care
survivorship
myelodysplastic syndromes
leukemia

Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer

Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.

palliative care
pain management

Leslie J. Blackhall, MD, on Unregulated Opioid Access: Consequences and Outcomes

Leslie J. Blackhall, MD, of the University of Virginia, discusses abuse of opioids, prescribing responsibly, and reducing cancer pain while also decreasing the risk of misusing these agents.

Expert Point of View: Jean-Pascal Machiels, MD, PhD, and Tanguy Seiwert, MD

Invited discussant Jean-Pascal Machiels, MD, PhD, Head of the Department of Medical Oncology at the Cliniques universitaires Saint-Luc, UCLouvain, Brussels, called the study “very important,” especially for showing that in patients with high expression of programmed cell death ligand 1 (PD-L1),...

head and neck cancer
immunotherapy

Pembrolizumab Improves Survival in Advanced Head and Neck Cancer

An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...

Expert Point of View: Julien Taieb, MD, PhD

The invited discussant for the CheckMate-142 findings was Julien Taieb, MD, PhD, Professor of Medicine at Paris Descartes University in France. Dr. Taieb called the findings “impressive” but said longer follow-up is needed, especially since median outcomes have not yet been reached. After a...

gastrointestinal cancer
colorectal cancer
immunotherapy

First-Line Immunotherapy Shows Benefit in Metastatic Colorectal Cancer Subset

In previously untreated patients with metastatic colorectal cancer and tumors demonstrating microsatellite instability–high (MSI-high) or mismatch repair deficiency (dMMR), immunotherapy with nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) produced a durable clinical benefit in the...

solid tumors
head and neck cancer

Ivy Brain Tumor Center to Study Treatments for Brain Malignancies

The Ben and Catherine Ivy Foundation, in partnership with the Barrow Neurological Institute in Phoenix, has awarded a $50 million grant to establish a new translational science program focusing on early-phase, pharmacodynamic- and pharmacokinetic-driven clinical trials for aggressive brain tumors. ...

prostate cancer

Treatment With ADT May Be Linked to Higher Risk of Heart Failure in Patients With Prostate Cancer

Androgen-deprivation therapy (ADT) use was associated with a higher risk of heart failure in a study of patients with prostate cancer, according to findings published by Kao et al in The Journal of Clinical Pharmacology.  Study Methods, Findings Study authors used data from the Taiwan...

issues in oncology
survivorship

ACS Report Looks at Ways to Improve Outcomes for Cancer Survivors and Caregivers

Growing numbers of cancer survivors, provider shortages, rising health-care costs, and socioeconomic disparities in health outcomes have created an urgent need to provide coordinated, comprehensive, personalized care for cancer survivors. A new report from the American Cancer Society (ACS) creates...

Expert Point of View: George Coukos, MD, PhD

George Coukos, MD, PhD, Director of the Department of Oncology at the University Hospitals of Canton Vaud and Director of the Lausanne branch of the Ludwig Institute for Cancer Research at the University of Lausanne in Switzerland, was the invited discussant of the NICHE study at the European...

gastrointestinal cancer

Neoadjuvant Immunotherapy Yields Major Response in Colon Cancer Subset

In a small study of patients with early-stage colon cancer, neoadjuvant ipilimumab (Yervoy) plus nivolumab (Opdivo) produced major pathologic responses in 100% of patients with mismatch repair (MMR)-deficient tumors but in none of the patients with MMR-proficient tumors, researchers reported at the ...

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