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issues in oncology
cost of care

How to Rein in Oncology Costs and Save Physician-Owned Practices

I was honored to contribute a chapter on the cancer care delivery system and how to improve it for the book A New Deal for Cancer: Lessons From a 50 Year War, edited by Abbe R. Gluck and Charles Fuchs, MD, MPH (Public Affairs, 2021). The book chronicles what has been accomplished in the 50 years...

global cancer care

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

The Russian Federation is the largest country in the world, extending from Eastern Europe to Northern Asia and the Pacific Ocean. The population of more than 140 million people is unevenly distributed across the country.1 As a result, Russia has high spatial inequality in terms of accessibility of...

breast cancer

RxPONDER Trial: Another Step in Defining Which Patients With Breast Cancer May Be Spared Adjuvant Cytotoxic Chemotherapy

As reported by Kalinsky et al and summarized in this issue of The ASCO Post, an interim analysis of the phase III RxPONDER trial showed that the addition of adjuvant chemotherapy to endocrine therapy improved invasive disease–free survival among premenopausal—but not postmenopausal—women with...

Hematologist and Bone Marrow Transplant Pioneer, Tahir Shamsi, MBBS, MRCPath, FRCPath, Dies at 59

Although bone marrow transplantation is routinely employed in the United States and other wealthy nations, this costly life-saving procedure has struggled to gain a foothold in many low- to moderate-income countries, where resources are triaged to make the best use of precious health-care funding. ...

breast cancer
genomics/genetics
immunotherapy

Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer

Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...

breast cancer

Evidence Supports Ovarian Function Suppression Plus Aromatase Inhibitor in Premenopausal Women With Early Breast Cancer

The benefits of ovarian function suppression were sustained long term for premenopausal women with hormone receptor–positive breast cancer, according to updates from SOFT and TEXT, two randomized, controlled trials, presented at the 2021 San Antonio Breast Cancer Symposium.1 A separate large...

leukemia

Fixed-Duration Venetoclax Plus Ibrutinib Achieves Deep and Durable MRD Remissions in CLL

Two different trials presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition found that fixed-duration treatment with ibrutinib and venetoclax achieved deep and sustained undetectable measurable residual disease (MRD) status when used as first-line therapy for...

issues in oncology

Oncology Drugs With Accelerated Approval: Is It Time for a Reset?

Regulations that are developed by the U.S. Food and Drug Administration (FDA) must have some shelf-life before revisions are considered. The FDA has several mechanisms to provide patients with more rapid access to medicines. One such pathway is accelerated approval. Backward Glance at Accelerated...

gastroesophageal cancer

Pretreatment Cardiovascular Disease and Events in Patients Receiving Curative-Intent Chemoradiation for Esophageal Cancer

In a Danish single-institution study reported in JACC: CardioOncology, Mette Marie A. Søndergaard, MD, of the Department of Cardiology, Aarhus University Hospital, Denmark, and colleagues found a high rate of undetected or inadequately treated preexisting cardiovascular disease (CVD) prior to...

multiple myeloma

In All Candor, What Does CANDOR Bring to the Table in Relapsed or Refractory Multiple Myeloma?

An updated analysis of the phase III CANDOR study—recently reported by Usmani et al and summarized in this issue of The ASCO Post—confirmed a significant progression-free survival benefit for the combination of daratumumab, carfilzomib, and dexamethasone (KdD) over carfilzomib and dexamethasone...

lung cancer

Mirek Fatyga, PhD, on NSCLC: New Data on Stereotactic Body Radiotherapy vs Conventionally Fractionated Radiotherapy

Mirek Fatyga, PhD, of Mayo Clinic Arizona, discusses his findings on overall survival in patients with locally advanced non–small cell lung cancer who are treated with stereotactic body radiotherapy or conventionally fractionated radiotherapy. He notes that a high dose of > 50 Gy to the...

gynecologic cancers

Efficacy of Trametinib in Recurrent Low-Grade Serous Ovarian Carcinoma

A study published by David Gershenson, MD, and colleagues in The Lancet reported that the MEK inhibitor trametinib reduced the risk of disease progression or death by 52% compared to standard-of-care therapies in low-grade serous ovarian carcinoma. The international, multicenter phase II/III trial...

colorectal cancer

SOLSTICE Trial: Trifluridine/Tipiracil Plus Bevacizumab in Metastatic Colorectal Cancer

For the treatment of metastatic colorectal cancer in patients unfit for intensive chemotherapy, trifluridine/tipiracil plus bevacizumab as first-line therapy was no more effective than capecitabine plus bevacizumab, investigators from the phase III SOLSTICE trial reported in a European Society for...

head and neck cancer

Reduced-Intensity Chemoradiotherapy in EBV DNA–Selected Locoregionally Advanced Nasopharyngeal Carcinoma

In a Chinese phase II trial reported in the Journal of Clinical Oncology, Li et al found that treatment with two cycles of concurrent cisplatin and intensity-modulated radiotherapy (IMRT) was noninferior to three cycles in progression-free survival and associated with reduced toxicity in patients...

breast cancer
immunotherapy

Use of Autologous Metastasis Mutation–Reactive TILs in Metastatic Breast Cancer

In a National Institutes of Health study reported in the Journal of Clinical Oncology, Zacharakis et al found that treatment with autologous tumor-infiltrating lymphocytes (TILs) reactive to mutations in metastatic lesions produced responses in patients with metastatic breast cancer. Study Details...

issues in oncology

Risk-Standardized Mortality Rates as Quality Proxy for Surgical Oncology

In a German study reported in the Journal of Clinical Oncology, Baum et al found that risk-standardized mortality rates may be a better-quality proxy for complex oncologic surgeries than hospital volume. As stated by the investigators, “Despite a long-known association between annual hospital...

breast cancer

Can Postsurgical Monoclonal Antibody Treatment Reduce HER2-Positive Early-Stage Breast Cancer Recurrence?

Treating women diagnosed with a certain type of early-stage breast cancer with the monoclonal antibody trastuzumab after surgery may reduce the risk of the cancer returning, according to a report published by Ali et al in Scientific Reports. The research team from the University of Saskatchewan...

breast cancer

Outcomes in a Large Cohort of Patients With Ultra-Low–Risk Breast Cancer: Analysis From the MINDACT Trial

As reported in the Journal of Clinical Oncology by Josephine M.N. Lopes Cardozo, MD, and colleagues, long-term follow-up in the phase III MINDACT trial has shown excellent outcomes among a large group of patients with ultra-low­–risk breast cancer as classified by the 70-gene signature assay, with...

leukemia

Study Finds Pediatric-Based Treatment Regimen Feasible and Effective in Older Adults With ALL

A pediatric-based protocol has delivered promising preliminary results in adults with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL), according to data presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Findings from the large,...

legislation

President Biden Reignites Cancer Moonshot

As Vice President, in 2016, Joe Biden launched the Cancer Moonshot with the mission to accelerate the rate of progress against cancer. The cancer and patient community and medical researchers responded with energy and ingenuity. On February 2, President Biden announced the reigniting of the Cancer ...

leukemia
genomics/genetics

Use of Polygenic Cytarabine Response Score to Identify Candidates With Pediatric AML for Chemotherapy Augmentation

In a study reported in the Journal of Clinical Oncology, Elsayed et al developed a risk score based on single nucleotide polymorphisms (SNPs) associated with cytarabine pharmacodynamics or clinical outcomes that identified pediatric patients with acute myeloid leukemia (AML) who could benefit from...

lung cancer
immunotherapy

Addition of Radiotherapy to Durvalumab Plus Tremelimumab in Patients With Metastatic NSCLC Refractory to PD-1/PD-L1 Inhibitor Therapy

In a phase II trial reported in The Lancet Oncology, Jonathan Schoenfeld, MD, and colleagues found that the addition of low-dose or hypofractionated radiotherapy to durvalumab plus tremelimumab did not improve objective response rates in patients with metastatic non–small cell lung cancer (NSCLC)...

gynecologic cancers

Invasive Cervical Cancer Prognosis According to High-Risk HPV Status

In a Swedish study reported in the Journal of Clinical Oncology, Lei et al found that patients with invasive cervical cancer and undetectable human papillomavirus (HPV) or infection with low-risk HPV types alone have poorer survival vs those with disease associated with high-risk HPV types. Study...

geriatric oncology

SIOG Annual Conference Explores the Past, Present, and Future of Geriatric Oncology

The 2021 Annual Conference of the International Society of Geriatric Oncology (SIOG) was held on November 4–5. Although participants could not join the conference in person, attendees could still stay informed about the latest developments in geriatric oncology through the virtual platform. The...

supportive care

Early Research Shows Low-Dose Light Therapy May Aid in Treating Skin Damage From Radiation Therapy

Light therapy may accelerate the healing of skin damage from radiation therapy by up to 50%, according to a recent study published by Mosca et al in Photonics. The preclinical research found that photobiomodulation—a form of low-dose light therapy—lowered the severity of skin damage from...

colorectal cancer

Young Adults May Have the Greatest Risk of Distant-Stage Colorectal Cancer, With the Highest Risk Among Black and Hispanic Patients

Colorectal cancer is the second most common cause of death in the United States. In 2020, approximately 148,000 people were diagnosed with the disease, and 53,200 people died from it, including 17,930 cases and 3,640 deaths in individuals younger than age 50. According to the American Cancer...

genomics/genetics

Risk of Multiple Cancers in Male Carriers of BRCA1 and BRCA2 Gene Mutations

People who carry the BRCA1 or BRCA2 gene mutation have an increased risk of pancreatic, stomach, and prostate cancers, as well as the previously well-known risk of breast and ovarian cancers, according to new research calling for increased testing in male carriers to detect the cancers early. The...

global cancer care

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

The ASCO Post is pleased to continue this occasional special focus on the worldwide cancer burden. In this issue, we feature a close look at the cancer incidence and mortality rates in Burundi. The aim of this special feature is to highlight the global cancer burden for various countries of the...

An Adventurous Spirit Led to a Prominent Role in Radiation Oncology for Geraldine Jacobson, MD, MPH, MBA, FACR, FASTRO

Geraldine Jacobson, MD, MPH, MBA, FACR, FASTRO, founding Chair of the West Virginia University (WVU) Department of Radiation Oncology, was born in Fort Dix, New Jersey. Her father was a military officer, and his various duty posts offered an adventurous childhood for Dr. Jacobson. “One of my...

From the Vietnam War to the Stanford Cancer Institute: The Professional Journey of Quynh-Thu Le, MD

In this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, FACP, spoke with Quynh-Thu Le, MD, Chair of the Department of Radiation Oncology and Co-Director of the Radiation Biology Program of the Stanford Cancer Institute, and one of the Group Chairs of the NRG Oncology...

skin cancer
immunotherapy

Circadian Timing of Immune Checkpoint Inhibitors: Beyond Good Times and Bad Times

After almost a century of limited efficacy of cancer immunotherapy,1 the breakthrough happened in 2012 with the discovery of immune checkpoint inhibitors,2,3 leading to the 2018 Nobel Prize in Physiology or Medicine for James P. Allison and Tasuku Honjo. Yet about 40% of patients on immune...

multiple myeloma

Isatuximab-Containing Induction Therapy for Multiple Myeloma Increases Measurable Residual Disease Negativity

For the first-line treatment of newly diagnosed multiple myeloma, the percentage of patients achieving measurable residual disease (MRD, previously called minimal residual disease) negativity was significantly greater when the anti-CD38 monoclonal antibody isatuximab was added to a standard...

lymphoma

Mosunetuzumab Meets Primary Endpoint of Phase II Trial in Relapsed or Refractory Follicular Lymphoma

The bispecific antibody mosunetuzumab achieved deep and durable remissions as monotherapy in patients with relapsed or refractory follicular lymphoma, according to the results of a pivotal phase II trial presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition.1 In ...

lymphoma

Lisocabtagene Maraleucel Improves Outcomes in Relapsed or Refractory Large B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy with lisocabtagene maraleucel could prove to be the new standard-of-care treatment for patients with relapsed or refractory large B-cell lymphoma in the second-line setting, according to data presented at the 2021 American Society of Hematology (ASH)...

multiple myeloma

Studies Evaluate Screening for Early Multiple Myeloma

Precursors to multiple myeloma were identified by population screening in two studies reported at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition. The prevalence of monoclonal gammopathies was determined in the PROMISE trial using cutting-edge technology in a high-risk ...

breast cancer
immunotherapy

Long-Term Outcomes After Neoadjuvant Chemotherapy With or Without Carboplatin and Bevacizumab for Triple-Negative Breast Cancer

In an analysis from the phase II CALGB 40603/Alliance trial reported in the Journal of Clinical Oncology, Shepherd et al found that the addition of carboplatin or bevacizumab to neoadjuvant chemotherapy was not associated with improved long-term outcomes in patients with stage II or III...

gastroesophageal cancer

Long-Term Swallowing Quality-of-Life Results With Radiotherapy vs Transoral Robotic Surgery for Oropharyngeal Cancer

In a long-term longitudinal analysis of the phase II ORATOR trial reported in the Journal of Clinical Oncology, Anthony Nichols, MD, and colleagues found that a statistically significant improvement in swallowing quality of life persisted through 3 years after treatment with radiotherapy vs...

myelodysplastic syndromes

PANTHER: No Significant Benefit for Pevonedistat Plus Azacitidine in Higher-Risk Myelodysplastic Syndrome

The phase III PANTHER trial, which evaluated pevonedistat plus azacitidine vs azacitidine alone in higher-risk myelodysplastic syndromes, chronic myelomonocytic leukemia, and low–blast count acute myeloid leukemia (AML), failed to meet its primary endpoint of event-free survival, though lessons...

gastroesophageal cancer

Selecting Patients With Barrett's Esophagus for Endoscopic Surveillance: Role of Nonendoscopic Device Biomarkers

In a study reported in The Lancet Oncology, Pilonis et al found that nonendoscopic cell collection device (marked as the Cytosponge)–detected atypia and p53 overexpression could be used in combination with clinical risk factors to triage patients with Barrett’s esophagus for endoscopic...

global cancer care

UICC to Launch 3-Year Campaign to Create More Equitable Access to Cancer Services

On February 4, 2022, the Union for International Cancer Control (UICC) will launch a new 3-year campaign for World Cancer Day that brings together individuals, organizations, and governments around the world in an effort to create awareness and help close the gap in cancer care. The campaign...

lung cancer
immunotherapy

Durvalumab/Tremelimumab With or Without Radiotherapy in Resistant NSCLC

In a recent phase II clinical trial, the combination of the PD-L1 inhibitor durvalumab and the CTLA-4 inhibitor tremelimumab curtailed tumor growth in some patients with non–small cell lung cancer (NSCLC) that was resistant to a single immunotherapy agent. The addition of radiation therapy to the...

kidney cancer
immunotherapy

First-Line Nivolumab/Cabozantinib vs Sunitinib for Advanced Renal Cell Carcinoma: Patient-Reported Outcomes

In an analysis from the phase III CheckMate 9ER trial reported in The Lancet Oncology, David Cella, PhD, FASCO, and colleagues found that nivolumab/cabozantinib was associated with maintained or improved patient-reported outcomes vs sunitinib in the first-line treatment of advanced renal cell...

breast cancer

RxPONDER Update Explores Benefit of Chemotherapy in Subgroups

Updated results of the SWOG S1007 RxPONDER trial confirmed the key takeaway from the previous analysis: adjuvant chemotherapy benefits premenopausal women but not postmenopausal women with hormone receptor–positive, HER2-negative disease, one to three positive lymph nodes, and a 21-gene Oncotype DX ...

leukemia

Study Finds Improved 2-Year Survival Rate for Adult Patients With Relapsed Philadelphia Chromosome–Positive ALL After Allogeneic Hematopoietic Cell Transplantation Over 20 Years

A retrospective, registry-based multicenter study by Bazarbachi et al published in Clinical Cancer Research evaluated clinical outcomes in patients with relapsed Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic cell transplantation over a...

gastroesophageal cancer

New Research Aims to Uncover Cellular Source of Barrett’s Esophagus

Two recent studies correct a long-standing misconception about the origins of Barrett’s esophagus and, in doing so, may point to new avenues of treatment or prevention to lower the risk of esophageal cancer. The first study, published by Singh et al in the journal Gastroenterology, demonstrated...

global cancer care

Global Burden of Cancer From 2010 to 2019

In an analysis reported in JAMA Oncology, researchers in the Global Burden of Disease 2019 Cancer Collaboration found a global increase in new cases of cancer, cancer deaths, and cancer-related disability-adjusted life-years (DALYs) between 2010 and 2019, with aspects of cancer burden differing...

hepatobiliary cancer

ASTRO Issues Clinical Guideline on External-Beam Radiation Therapy for Primary Liver Cancers

A clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of radiation therapy to treat adult patients with primary liver cancers using external-beam radiation therapy (EBRT). Evidence-based recommendations outline indications and optimal EBRT...

survivorship

Effect of Daily Sitting Time and Weekly Physical Activity on Cancer Survivorship

In a study reported in JAMA Oncology, Cao et al found that the combination of increased daily sitting time and low weekly leisure-time physical activity was associated with poorer overall and cancer-specific survival among U.S. cancer survivors. Study Details The study involved data from a...

multiple myeloma
genomics/genetics

Anil Aktas-Samur, PhD, on Identifying Low-Risk Smoldering Multiple Myeloma

Anil Aktas-Samur, PhD, of Dana-Farber Cancer Institute, discusses study findings on the genomic characterization of non-progressor smoldering multiple myeloma, results that may provide a molecular definition of the disease as well as its risk-driving features. Combining this low-risk model with...

leukemia

Incidence of Chronic Graft-vs-Host Disease: Effect of Depleting Naive T Cells From Peripheral Blood Stem Cell Allografts in Patients With Leukemia

Although allogeneic hematopoietic cell transplantation can result in a cure for patients with advanced hematologic malignancies, studies show chronic graft-vs-host disease occurs in 30% to 60% of patients receiving unmanipulated grafts, often requires prolonged immunosuppression, and may cause...

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