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cost of care

ASCO Offers Path to Addressing Affordability of Cancer Drugs in New Position Statement

Today, ASCO issued a position statement aimed at contributing to the national dialogue on rising cancer drug prices. The statement, which asserts that any solutions must also preserve patients' access to care and foster innovation, analyzes a wide array of options and recommends that a panel of...

hepatobiliary cancer

FDA Approves Three-Drug Combination Tablet for Hepatitis C

On July 18, the U.S. Food and Drug Administration (FDA) approved a combination tablet (Vosevi) to treat adults with chronic hepatitis C virus genotypes 1–6 without cirrhosis or with mild cirrhosis. This fixed-dose, combination tablet contains two previously approved drugs—sofosbuvir and ...

issues in oncology

Understanding of Stage and Cancer Status Among Patients in a Community-Based Cancer Institute

As reported by Sivendran et al in the Journal of Oncology Practice, half of patients in a large community-based cancer institute did not know their stage of cancer, and one-third did not know of their cancer-free/in-remission status. Study Details The study involved 208 adult patients treated at...

kidney cancer

Nivolumab Plus Ipilimumab in Metastatic Renal Cell Carcinoma

The phase I CheckMate 016 trial has shown activity of the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) in metastatic renal cell carcinoma. These findings were reported in the Journal of Clinical Oncology by Hammers et al. Study Details In the dose-escalation study, patients were...

cns cancers

Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Resected Metastatic Brain Disease

In the phase III NCCTG N107C/CEC.3 trial, stereotactic radiosurgery to the surgical cavity reduced cognitive deterioration and was associated with similar overall survival vs whole-brain radiotherapy in patients with resected brain metastasis. These results were reported by Brown et al in The...

Edus H. Warren, MD, PhD, Named Leader of Fred Hutch Global Oncology Program

Immunotherapy researcher and oncologist Edus H. Warren, MD, PhD, has been selected to lead the Fred Hutchinson Cancer Research Center (Fred Hutch) program in Global Oncology in its effort to transform cancer care in sub-Saharan Africa, China, and other regions by providing greater access to the...

skin cancer

Spark Discussions About Indoor-Tanning Devices

“Strong evidence suggests that using a tanning bed during adolescence or young adulthood can increase the risk of early-onset melanoma by over 40%,” Jeffrey E. Gershenwald, MD, wrote in an opinion piece for Newsweek.1 Dr. Gershenwald is Professor of Surgical Oncology, Medical Director of the...

skin cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

lung cancer

Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer

A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...

bladder cancer

Avelumab in Refractory Metastatic Urothelial Carcinoma

The programmed cell death ligand 1 (PD-L1)–inhibitor avelumab (Bavencio) has shown activity in patients with refractory metastatic urothelial cancer, according to findings in a phase Ib study reported by Andrea B. Apolo, MD, of the Genitourinary Malignancies Branch, Center for Cancer Research,...

supportive care
integrative oncology

Music Therapy: Relevance in Oncology

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Karen Popkin, LCAT, MT-BC, and Jyothirmai Gubili, MS, present the case ...

integrative oncology

Shiitake Mushroom: Insufficient Evidence to Support It Boosts Immune System

In the June 25 issue of The ASCO Post, the Integrative Oncology column by Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, focused on how to counsel a patient about shiitake mushroom. They concluded: “We advised our patient that it is safe to take shiitake mushroom to boost her immune system.”...

A Frank Memoir About Doctors, Patients, and the Health-Care System

“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...

pancreatic cancer

Stereotactic Body Radiotherapy for Poor Performance Status Patients With Pancreatic Cancer

There are few data to guide the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have a poor performance status. Although most such patients are offered supportive care or gemcitabine alone, the addition of stereotactic body radiotherapy may improve...

multiple myeloma
survivorship

Living With Cancer Survivorship Guilt

Although I was officially diagnosed with multiple myeloma in 1997, the first sign of the cancer was evident 2 years earlier, when a single lesion (a plasmacytoma) was found in a bone in my lower back. The bone was replaced with two thin stainless steel rods, and after a course of radiation therapy, ...

Huntsman Unveils New Primary Children’s and Families’ Cancer Research Center

On June 21, 2017, the Huntsman Cancer Institute (HCI) at the University of Utah announced the official opening of its Primary Children’s and Families’ Cancer Research Center, a world-class facility dedicated to advancing research in cancer. Jon M. Huntsman also announced a commitment from the...

A Social Media Guide by a Doctor for Doctors

Today’s brave new world of digital technology has both enhanced and compromised the day-to-day operational efficiency of ultrabusy oncologists who are struggling to balance patient care with the rapid evolution of technology. Like all scientific advances, health-care technology is a double-edged...

supportive care
palliative care

Ensuring Advance Directives Are Followed and Lawsuits Are Avoided

Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...

supportive care
palliative care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

lung cancer

Adding Pravastatin to Chemotherapy in Small Cell Lung Cancer

Following early reports associating favorable outcomes in cancer patients with the use of statins,1,2 further observational studies in this area have provided mixed findings.3 As recently reported in the Journal of Clinical Oncology, and reviewed in this issue of The ASCO Post, Seckl and colleagues ...

lung cancer

No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer

In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer...

breast cancer
solid tumors

CDK4/6 Inhibitors Have a Manageable Toxicity Profile, Are Generally Well Tolerated in Patients With Breast Cancer

A class of oral drugs for treating breast cancer known as cyclin-dependent kinase (CDK) 4/6 inhibitors are generally well-tolerated, with a manageable toxicity profile for most patients. This is the conclusion of a comprehensive review of toxicities and drug interactions related to this class of...

breast cancer

Neoadjuvant Radiation Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Moffitt Cancer Center researchers conducted a first-of-its-kind study comparing the long-term benefits of radiation therapy in women with breast cancer in the neoadjuvant and adjuvant settings. Their study, published by Poleszczuk et al in Breast Cancer Research, found that patients who have...

issues in oncology

The Immune System: Deciphering Recent Advances

Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the...

issues in oncology

FDA Takes Action Against 14 Companies for Selling Illegal Cancer Treatments

On April 25, the U.S. Food and Drug Administration (FDA) posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat, or cure cancer. The products are marketed and sold without FDA approval, most commonly...

solid tumors

Insertion and Deletion Mutations and Immunogenicity in Solid Tumors

In a study reported in The Lancet Oncology, Turajlic et al found that renal cell carcinomas were characterized by the highest proportion and number of frameshift insertion and deletion (indel) mutations among solid cancers and that these alterations were associated with augmented immunogenicity...

leukemia

Effect of Methotrexate and Corticosteroid Strategies on Neurocognitive Function in Patients With B-Lineage ALL

In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia regardless of...

breast cancer

MammaPrint Scoring and Indolent Node-Negative Breast Cancer

In an analysis reported in JAMA Oncology, Esserman et al found that an ultralow-risk designation using the 70-gene MammaPrint assay is capable of identifying patients with node-negative disease who have a very low long-term risk of death from breast cancer after surgery without systemic therapy....

breast cancer

FDA Approves Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

Today, the U.S. Food and Drug Administration approved neratinib (Nerlynx) for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab (Herceptin)-based therapy. ExteNET Trial Approval was based on the ExteNET...

supportive care

Appropriate Distress Screening and Follow-up Leads to Fewer ER Visits and Hospitalizations in Patients With Cancer

Following a cancer diagnosis, all patients experience some level of distress—regardless of disease stage. When severe and left untreated, distress can have a significant impact on health outcomes, lead to greater mortality and morbidity, affect immune function, and result in higher...

solid tumors
issues in oncology

ASTRO Updates Insurance Coverage Recommendations for Proton Therapy

The American Society for Radiation Oncology (ASTRO) has issued an update to its recommendations for medical insurance coverage regarding the use of proton beam therapy to treat cancer. The updated Proton Beam Therapy Model Policy provides guidance to payers on clinical indications that are...

skin cancer

Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma

In a retrospective analysis reported in JAMA Oncology, Long et al found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1–defined disease...

leukemia

CD33 Splicing Polymorphism and Response to Gemtuzumab Ozogamicin in AML

In an analysis of the phase III Children’s Oncology Group AAML0531 trial, published by Lambda et al in the Journal of Clinical Oncology, the CD33-targeted immunoconjugate gemtuzumab ozogamicin was shown to have benefit among patients with de novo acute myeloid leukemia (AML) who carry the CC...

FDA’s ODAC Unanimously Recommends Biosimilar Versions of Bevacizumab and Trastuzumab

On July 13, the U.S. Food and Drug Administration's (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously recommended approval of biosimilar versions of bevacizumab (Avastin) and trastuzumab (Herceptin). In the morning session, ODAC members voted 17-0 in favor of approving Amgen's...

issues in oncology

Cancer Risk May Be Higher Among Holocaust Survivors

A new study indicates that survivors of the Holocaust have experienced a small but consistent increase in the risk of developing cancer. Published by Sadetzki et al in Cancer, the findings offer an example of how extreme population-level tragedies can have an impact on health. Holocaust survivors...

breast cancer

Anthracycline-Free Adjuvant Treatment in Early TOP2A-Normal Breast Cancer

The Danish phase III DBCG 07-READ trial has shown no difference in disease-free survival with adjuvant docetaxel/cyclophosphamide vs epirubicin, cyclophosphamide, and docetaxel in patients with early TOP2A-normal breast cancer. These trial results were reported in the Journal of Clinical Oncology...

cns cancers
issues in oncology

Study Demonstrates Potential for Artificial Intelligence and Whole-Genome Sequencing to Scale Access to Precision Medicine

In a study published by Wrzeszczynski et al in Neurology: Genetics, researchers at the New York Genome Center (NYGC), The Rockefeller University, and IBM illustrated the potential of IBM Watson for Genomics to analyze complex genomic data from state-of-the-art sequencing of whole genomes. The study ...

issues in oncology

New CDC Report Shows Cancer Death Rates Are Higher in Rural America

Despite decreases in cancer death rates nationwide, a new report from the Centers for Disease Control and Prevention (CDC) shows slower reduction in cancer death rates in rural America (a decrease of 1.0% per year) compared with urban America (a decrease of 1.6% per year), according to data...

leukemia

FDA’s Advisory Committee Supports CTL019 in Pediatric, Young Adult Patients With B-Cell ALL

Today, the U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) met to discuss the biologics license application (BLA) for the chimeric antigen receptor (CAR) T-cell therapy CTL019 (tisagenlecleucel) for the treatment of relapsed or refractory pediatric and young adult...

Impact of Health Insurance and Sociodemographic Status on Survival for AYAs With Cancer

According to the National Cancer Institute, cancer is the leading cause of disease-related death among adolescents and young adults (AYAs) between the ages of 15 and 39. And although cancer survival among this age group is more than 80%, AYAs have not experienced the same improvements in relative...

leukemia

Blinatumomab Granted Full Approval to Treat Relapsed or Refractory B-cell Precursor ALL in Adults and Children

On July 11, the U.S. Food and Drug Administration (FDA) approved the supplemental Biologics License Application (sBLA) for blinatumomab (Blincyto) to include overall survival data from the phase III TOWER study. The approval converts blinatumomab's accelerated approval to a full approval. The sBLA...

lung cancer

FDA Approves First Companion Diagnostic Test to Simultaneously Screen for Multiple NSCLC Therapies

On June 22, the U.S. Food and Drug Administration (FDA) granted premarket approval to Thermo Fisher Scientific for the first next-generation sequencing–based test that simultaneously screens tumor samples for biomarkers associated with three FDA-approved therapies for non–small cell...

breast cancer

Priority Review Granted for Abemaciclib in the Treatment of Advanced Breast Cancer

On July 10, the U.S. Food and Drug Administration (FDA) accepted a new drug application (NDA) for abemaciclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor, and gave the NDA a Priority Review designation. The NDA includes Eli Lilly and Company’s submission of abemaciclib for two indications: ...

leukemia

FDA Accepts sNDA for Dasatinib in Pediatric Patients With Philadelphia Chromosome–Positive Chronic-Phase CML

On July 10, the U.S. Food and Drug Administration (FDA) accepted a supplemental new drug application (sNDA) to include an indication for dasatinib (Sprycel) to treat children with Philadelphia chromosome–positive chronic-phase chronic myeloid leukemia (CML), as well as a powder for oral...

issues in oncology

Factors Associated With Near-Miss/Safety Incidents in Cancer Radiotherapy

In a single-institution case-control analysis reported in the Journal of Oncology Practice, Judy et al found that complexity of procedure or schedule was a significant factor in near-miss or safety incidents involving cancer patients undergoing radiotherapy. Study Details The study involved a...

breast cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The...

health-care policy
issues in oncology

Narrow Network Insurance Plans More Likely to Exclude Doctors at NCI-Designated and NCCN Member Cancer Centers

Patients with cancer in the United States may be unable to access care at the nation’s top hospitals due to narrow insurance plan coverage—leaving patients to choose between lower premiums or access to higher-quality cancer care. A new study from the Perelman School of Medicine at the...

skin cancer
issues in oncology

Delaying Lymph Node Biopsy After Melanoma Diagnosis May Not Adversely Affect Survival Rates

Postponing lymph node biopsy more than 30 days after melanoma diagnosis does not adversely impact long-term clinical outcomes, according to findings published by Nelson et al in the Journal of the American College of Surgeons. Today, management of high-risk melanomas starts with surgical removal...

breast cancer

Effect of Patient-Reported Symptoms on Adherence to Preventive Treatment for Breast Cancer

In an analysis of the UK cohort of the International Breast Cancer Intervention Study (IBIS-I) reported in the Journal of Clinical Oncology, Smith et al found similar effects of predefined symptoms on nonadherence in both tamoxifen and placebo recipients. IBIS-I randomized women at high risk of...

gynecologic cancers

Current Performance Measures for Cervical Cancer Screening

Health-care systems use performance measures for cervical cancer screening based on guidelines from such organizations as the American College of Obstetricians and Gynecologists to monitor the appropriateness of cervical cancer screening. According to the performance measure in the Healthcare...

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