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His steps generated a low rumble that propagated through the floor like a tsunami, flowed up through my desk, and ended as tiny waves visible through the clear plastic of my water bottle. His custom Lucchese ostrich boots made a distinctive clicking sound as they rhythmically struck the tile floor, ...
Debating the Role of Opioids in the Management of Chronic Cancer Pain
Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...
Otis W. Brawley, MD, MACP, FASCO: Doctor, Policy Advocate, Writer, and Champion of the Underserved
In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, spoke with Otis W. Brawley, MD, MACP, FASCO, a global leader in cancer research and health disparities. Dr. Brawley, who served as Chief Medical and Scientific Officer for the American Cancer Society (ACS) and...
Francoise Mornex, MD, PhD, Named First Female Recipient of Heine H. Hansen Award
The European Society for Medical Oncology (ESMO) and the International Association for the Study of Lung Cancer (IASLC) recently awarded the 2019 Heine H. Hansen Award to Francoise Mornex, MD, PhD. The award was presented at the 2019 European Lung Cancer Congress. Dr. Mornex is Professor of...
Measuring the Burden of Global Cancer as a Tool for Policymakers
The Global Burden of Disease Study was initiated in 1990, commissioned by the World Bank. At that time, the study was conducted mainly by researchers at Harvard and the World Health Organization (WHO). Since then the study has gone through many iterations to its present structure, which is a...
Uniting the Global Cancer Community to Reduce Deaths From Noncommunicable Diseases
It has been well documented that noncommunicable diseases, including cancer, cardiovascular disease, and diabetes, now pose the greatest health threat to people living in low- and middle-income countries, surpassing infectious diseases like HIV/AIDS as the leading cause of death and disability.1...
How Cancer Affects Adolescents and Young Adults
The statistics are alarming: according to the National Cancer Institute (NCI), about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer each year1—a recent report by the University of California put that figure at 87,000.2 Although overall cancer survival rates continue to improve ...
NCCN Roundtable Tackles Issues With Innovative Immunotherapies
Immunotherapies are radically changing outcomes, but while helping patients, they are creating complexities surrounding their cost. At the 2019 Annual Conference of the National Comprehensive Cancer Network® (NCCN®), a roundtable of experts, including clinicians and payers, discussed how chimeric...
Combination Immunotherapy With Lenalidomide Plus Rituximab in Indolent NHL: Time to Replace Rituximab Monotherapy?
With increasing knowledge on the key role of the tumor microenvironment in lymphomagenesis, treatments for indolent B-cell lymphoma, especially follicular lymphoma, are mechanistically moving toward a more immunomodulatory approach. Chemotherapy-free regimens are an attractive alternative to...
Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL
Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...
Targeted Brachytherapy May Improve Outcomes in Recurrent Brain Tumors
For recurrent, previously irradiated brain tumors, innovative treatment with surgically targeted brachytherapy yielded good local control and overall survival, as compared to historic controls, neurosurgeons reported at the 2019 Annual Scientific Meeting of the American Association of Neurological...
T-Cell Therapy for EBV-Associated Posttransplant Lymphoproliferative Disorder With CNS Involvement
An “off-the-shelf” allogeneic T-cell product, tabelecleucel, may effectively treat patients who develop Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder with central nervous system (CNS) involvement, researchers from Memorial Sloan Kettering Cancer Center reported at...
FDA Approves T-DM1 for HER2-Positive Early Breast Cancer
On May 3, the U.S. Food and Drug Administration (FDA) approved ado-trastuzumab emtansine (T-DM1; Kadcyla) for the adjuvant treatment of patients with HER2-positive early breast cancer who have residual invasive disease after neoadjuvant taxane- and trastuzumab-based treatment. Patients should be...
Cytoreductive Nephrectomy in Patients With Metastatic RCC Treated With Sunitinib
In a trial with a modified primary endpoint due to slow accrual reported in JAMA Oncology,1 Axel Bex, MD, PhD, and colleagues found that deferred cytoreductive nephrectomy after sunitinib did not improve the 28-week progression-free rate vs immediate nephrectomy followed by sunitinib in patients...
Expert Point of View: Armin Shahrokni, MD
“Older and frail adults with cancer are the types of patients we deal with every day,” said Armin Shahrokni, MD, a geriatric oncologist at Memorial Sloan Kettering Cancer Center in New York. “The GO2 study is important, and I suspect it will be practice-changing,” he predicted. Older and frail...
A Year in Review
The past year has seen groundbreaking advances in the treatment of genitourinary (GU) cancers, which in some cases are resulting in altering the standard of care for patients with renal cell carcinoma, prostate cancer, and urothelial carcinoma. Some of the biggest changes that have occurred are for ...
Incoming ASCO President Sets His Sights on Conquering Cancer
For more than 3 decades, Howard A. “Skip” Burris III, MD, FACP, FASCO, has dedicated his medical career to researching the development of chemotherapies for breast cancer, including ado-trastuzumab emtansine, everolimus, and gemcitabine. In addition, he is credited with changing the standard of...
Evidence Builds for Treating Smoldering Myeloma
In patients with intermediate- to high-risk smoldering multiple myeloma, treatment with single-agent lenalidomide, vs observation, led to a 72% reduction in the risk of disease progression at 3 years.1 Results of the phase III E3A06 study were presented at a press briefing in advance of the 2019...
Conquer Cancer and Swim Across America: Making Waves to Fight Cancer
ASCO and ASCO’s Conquer Cancer Foundation have a new partner in supporting innovative cancer research. For over 30 years, Swim Across America (SAA) has been hosting charity swims, with the proceeds being granted to fund high-risk, high-reward cancer research. SAA is among the newest organizations...
Study Finds Immune Enrichment Improves Outcomes in Pancreatic Cancer With Activated but Not Normal Stroma
ALTHOUGH IMMUNOTHERAPIES have had limited success in pancreatic cancer to date, findings from a molecular analysis of the tumor microenvironment suggest that certain subtypes may be more responsive to treatment. According to data presented at the 2019 Society of Surgical Oncology Annual Cancer...
Pembrolizumab as Third-Line Option for Extensive-Stage Small Cell Lung Cancer
USE OF the anti–programmed cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab after two or more prior lines of therapy led to responses in patients with advanced small cell lung cancer (SCLC) in a pooled analysis of two clinical trials: phase Ib KEYNOTE-028 and phase II...
Expert Point of View: Namrata Vijayvergia, MD
NAMRATA VIJAYVERGIA, MD, of Fox Chase Cancer Center, Philadelphia, commented on this study. “This is an important study because it is done in a rare tumor type; not a lot of clinical trials are conducted in this disease. Recently, three other studies of single-agent therapy with checkpoint...
Dual-Immunotherapy Approach Shows Efficacy in High-Grade Neuroendocrine Tumors
COMBINING TWO established immunotherapy agents achieved tumor shrinkage in rare, aggressive, extrapancreatic high-grade neuroendocrine tumors, according to the results of SWOG S1609, a phase II clinical basket trial also known as DART (Dual Anti– CLTA-4 and Anti–PD-1 Blockade in Rare Tumors). The...
Expert Point of View: Roy S. Herbst, MD, PhD
FORMAL STUDY discussant, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at the Yale Cancer Center, New Haven, Connecticut, stated that the findings of the TATTON analyses are “compelling,” and the combination of osimertinib plus savolitinib can be considered a “win,” although randomized trials...
Neoadjuvant Immunotherapy Associated With Improved Outcomes in Patients With Locally Advanced Melanoma
ACCORDING TO DATA from a small prospective study presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium,1 neoadjuvant immunotherapy significantly prolonged relapse-free survival vs adjuvant immunotherapy in patients with stage III or oligometastatic stage IV melanoma intended...
ESTRO 38: REQUITE Project Finds Predictive Biomarkers for Late Radiotherapy Toxicity
The latest results from the REQUITE project, which aimed to discover what makes patients more likely to experience adverse effects after radiotherapy, have shown that a combination of biologic markers and certain genetic changes can predict radiation sensitivity. In addition, the international team ...
ESTRO 38: What Type of Radiotherapy May Best Preserve Cognitive Function in Pediatric Patients With Brain Tumors?
A comparison of three types of radiotherapy for pediatric brain tumors suggests that a type of proton therapy called pencil-beam scanning (PBS) offers the best hope of preserving cognitive functions. The study, presented by Toussaint et al at ESTRO 38, the annual congress of the European Society...
ESTRO 38: High–Dose Rate Brachytherapy in Localized Prostate Cancer
A single high dose of radiation that can be delivered directly to a treatment site within a few minutes is a safe and effective technique for treating men with localized, low-risk prostate cancer, according to a study presented by Tharmalingam et al at ESTRO 38, the annual congress of the ...
ESTRO 38: Radical Hemithoracic Therapy in Patients With Mesothelioma
Patients with mesothelioma are twice as likely to survive for 2 years or longer if they are treated with a high dose of radiation to the affected side of the trunk, according to research presented by Minatel et al at ESTRO 38, the annual congress of the European Society for Radiotherapy...
ESMO Breast Cancer 2019: Does Continuous Chemotherapy Benefit Patients With Advanced Breast Cancer?
Continuous chemotherapy showed greater benefit in patients with advanced breast cancer by both improving survival and maintaining quality of life compared to intermittent scheduling, according to analyses of the Stop&Go study presented by Erdkamp et al and Claessens et al at the European...
Hope and Fear Are Two Constants in the Lives of Patients With Cancer
A year and a half ago, when I was 33, the thought of having a life-threatening disease was unimaginable. In hindsight, the weight loss I began experiencing in the fall of 2017 should have raised concern because I’ve always had to be mindful of my diet if I wanted to lose weight. But denial can be a ...
Expert Point of View: Charles B. Simone II, MD
In a press briefing that preceded the 2019 Multidisciplinary Thoracic Cancers Symposium, Charles B. Simone II, MD, a radiation oncologist and Chief Medical Officer at the New York Proton Center, noted that this study should help clinicians better understand the impact of local therapy for patients ...
OneOncology Announces Lee Schwartzberg, MD, FACP, as Chief Medical Officer
OneOncology, the national partnership of community oncologists, has announced that Lee Schwartzberg, MD, FACP, has been named Chief Medical Officer. The Chief Medical Officer position provides a link between OneOncology and its physician partners, demonstrating the shared, foundational commitment...
New ASCO Guidelines on Early Detection and Treatment of Colorectal Cancer in Resource-Stratified Settings
ASCO has approved two new resource-stratified guidelines aimed at improving the early detection and treatment of colorectal cancer in all resource settings. The guidelines are a continuation of ASCO’s efforts to provide evidence-based recommendations for the management of malignancies applicable...
PRIMeR Study Explores Meaning of Minimal Residual Disease in Myeloma
In a study that earned a Best Abstract Award at the 2019 Transplantation & Cellular Therapy (TCT) Meetings in Houston, minimal residual disease (MRD) negativity at 1 year after autologous hematopoietic cell transplant (HCT) and maintenance lenalidomide therapy was an independent prognostic...
Biomarkers Can Now Help Guide Treatment Selections in Breast Cancer
A growing list of biomarkers is beginning to drive targeted therapy in breast cancer, and clinicians can take advantage of these assays to make treatment selections, Debu Tripathy, MD, Professor of Medicine and Chair of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center,...
Online Tool May Improve Guideline Concordance for Patients With Lung Cancer
An online tool that allows patients to input their clinical and pathologic features as well as explore treatment options in a structured manner based on National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology (NCCN Guidelines) may help drive smoking cessation and testing for ...
Role of Repeat PET/CT Scans in Ensuring Accuracy of Staging of Locally Advanced NSCLC
Findings from a new study highlight the importance of timing in initial staging positron-emission tomography (PET) and/or computed tomography (CT) scans for patients with locally advanced non–small cell lung cancer (NSCLC) receiving chemoradiation therapy.1 According to data presented at the 2019...
Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes in Lung Cancer
Frailty and sarcopenia are common conditions among patients with lung cancer and are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care. If a survey of oncologists at the 2019 Multidisciplinary Thoracic Cancers Symposium is any...
The Boy I Never Knew
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,...
The Evolving Role of Pathologists in the Diagnosis and Treatment of Cancer
In the past, the role of the pathologist was primarily to present anatomic pathology findings on various specimens, particularly at tumor boards. However, in the emerging age of personalized medicine and molecular diagnostics, the responsibilities of pathologist have greatly expanded into...
Robert A. Kyle, MD, Luminary in Myeloma Research: Journey From a One-Room Schoolhouse to Groundbreaking Research
In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, interviewed multiple myeloma pioneer Robert A. Kyle, MD, whose groundbreaking work has changed the practice of hematology. Among his many honors are the David A. Karnofsky Memorial Award from ASCO and the Wallace H....
Shared Decision-Making in Lung Cancer Screening: Whence? Whither?
We read with interest a recent article published on ASCOPost.com, which summarized a paper on the role of shared decision-making in lung cancer screening.1,2 The summary and original report highlight a mandate by the Centers for Medicare & Medicaid Services (CMS) that bears careful...
The Microbiome: The Next Target in Cancer Therapy
With the recent breakthroughs in immunotherapy, treatments that modulate the immune system are now being used across numerous cancer types and across the spectrum of disease with significant success, but not all patients achieve objective responses. There is still a critical need to better...
Conquer Cancer Foundation Announces 2019 ASCO Annual Meeting Merit Awards
The Conquer Cancer Foundation of ASCO has announced the recipients of its 2019 ASCO Annual Meeting Merit Awards. These distinguished awards support oncology trainees who are first authors on abstracts selected for presentation at the ASCO Annual Meeting. This year, Conquer Cancer will...
Read the Latest Posts on JOP DAiS
THE JOURNAL of Oncology Practice Discussion and Analysis in Short (JOP DAiS) blog provides health-care professionals with concise, to-the-point pieces about the latest information in cancer care delivery. Visit jopblog.org to read new posts, including “Three Must-see Talks From the ASCO Quality...
Human Gene Therapy: Progress and Oversight
The early debate over the social and ethical implications of gene therapy led the National Institutes of Health (NIH) to establish the Recombinant DNA Advisory Committee in 1974. However, the risks of human gene therapies were largely unknown until 1999, when a patient died of a massive immune...
The Future of Immunotherapy: Building on Checkpoint Blockade
THE EMERGENCE of anticancer agents that block immune checkpoints has transformed the field of oncology, leading to durable responses and improvements in overall survival in melanoma, renal cell carcinoma, head/neck squamous cell carcinoma, urothelial bladder cancer, and non–small cell lung cancer....
Fine-Tuning an ‘Airport Diagnosis’
HIS HEAD WAS DIFFERENT from those of the other people in line. He bore a matrix of white rows of circular patches on his shaved scalp like a wig. The patches were electrodes, connected by cords to a power supply in a satchel around his shoulder. I was able to make an instant and unfortunate...
VISTA Checkpoint Implicated in Pancreatic Cancer Immunotherapy Resistance
Researchers have identified a new potential immunotherapy target in pancreatic cancer, which so far has been notoriously resistant to treatment with immune checkpoint blockade drugs effective against a variety of other cancers. A research team from The University of Texas MD Anderson Cancer Center...
